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Derginin Adı:
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Diabetes Mellitus
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Cilt:
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2009/12
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Sayı:
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4
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Makale Başlık:
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Initial glucose-lowering therapy and risks of overall and cardiovascular mortality, myocardial infarction and stroke in patients with type2 diabetes
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Makale Alternatif Dilde Başlık:
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Риски общей и сердечно-сосудистойсмертности, а также инфаркта миокардаи острого нарушения мозговогокровообращения у больных сахарным диабетом2 типа в зависимости от вида стартовойсахароснижающей терапии
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Makale Eklenme Tarihi:
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12.08.2015
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Okunma Sayısı:
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1
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Makale Özeti:
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Aim. To assess association of oral hypoglycemic therapy regimens prescribed after onset of diabetes with overall and cardiovascular mortality and
risk of fatal and non-fatal myocardial infarction and stroke in patients with type 2 diabetes.
Materials and methods. Based on the results of a retrospective open cohort study, the 5-year risk of overall and cardiovascular mortality, myocardial
infarction and stroke was estimated in patients with type 2 diabetes diagnosed in 2004 and treated by various oral hypoglycemic agents. Cox regression
analysis was used to assess the risk of death from any course, death from cardiovascular disease, myocardial infarction and stroke.
Results. Patients with type 2 diabetes treated with sulfonylurea drugs showed a significant 2-fold increase of overall and cardiovascular mortality risk
(p<0,01), 4,6-fold increase of myocardial infarction risk (p<0,01), 3-fold increase of stroke risk (p<0,01), and 5-fold increase of death risk compared
with the metformin group (after stratification by age). The risk of total mortality, myocardial infarction, and stroke was higher in patients treated with
glibenclamide, gliclazide, and gliquidone than in the metformin group. Patients treated with gliclazide had a significantly lower risk of overall and
cardiovascular mortality in comparison with the glibenclamide group.
Conclusion. Given the lower risk of complications in patients given metformin therapy, it is necessary to use it as the first-line treatment of patients
with newly diagnosed type 2 diabetes.
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Alternatif Dilde Özet:
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Aim. To assess association of oral hypoglycemic therapy regimens prescribed after onset of diabetes with overall and cardiovascular mortality and
risk of fatal and non-fatal myocardial infarction and stroke in patients with type 2 diabetes.
Materials and methods. Based on the results of a retrospective open cohort study, the 5-year risk of overall and cardiovascular mortality, myocardial
infarction and stroke was estimated in patients with type 2 diabetes diagnosed in 2004 and treated by various oral hypoglycemic agents. Cox regression
analysis was used to assess the risk of death from any course, death from cardiovascular disease, myocardial infarction and stroke.
Results. Patients with type 2 diabetes treated with sulfonylurea drugs showed a significant 2-fold increase of overall and cardiovascular mortality risk
(p<0,01), 4,6-fold increase of myocardial infarction risk (p<0,01), 3-fold increase of stroke risk (p<0,01), and 5-fold increase of death risk compared
with the metformin group (after stratification by age). The risk of total mortality, myocardial infarction, and stroke was higher in patients treated with
glibenclamide, gliclazide, and gliquidone than in the metformin group. Patients treated with gliclazide had a significantly lower risk of overall and
cardiovascular mortality in comparison with the glibenclamide group.
Conclusion. Given the lower risk of complications in patients given metformin therapy, it is necessary to use it as the first-line treatment of patients
with newly diagnosed type 2 diabetes.
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