scholarly journals Vildagliptin Has a Neutral Association With Dementia Risk in Type 2 Diabetes Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cumulative Dose ◽  
Animal Studies ◽  
Matched Pair ◽  
Matched Cohort ◽  
Continuous Variables ◽  
Dementia Risk ◽  
Cumulative Duration

Background and aimsAnimal studies suggested that vildagliptin might exert a beneficial effect on cognitive function. The present study evaluated whether the use of vildagliptin in patients with type 2 diabetes mellitus might affect dementia risk.MethodsThe database of Taiwan’s National Health Insurance was used to enroll an unmatched cohort and a propensity score-matched-pair cohort of ever and never users of vildagliptin from patients with newly diagnosed diabetes mellitus during 2002-2014. The patients should be alive on January 1, 2015 and were followed up for dementia diagnosis until December 31, 2016. Unadjusted and multivariate-adjusted hazard ratios (HR) and their 95% confidence intervals (CI) were estimated for vildagliptin ever versus never users, for cumulative duration and cumulative dose of vildagliptin therapy categorized into tertiles versus never users, and for cumulative duration and cumulative dose treated as continuous variables.ResultsThere were 355610 never users and 43196 ever users in the unmatched cohort and 40489 never users and 40489 ever users in the matched cohort. In the unmatched cohort, unadjusted HR (95% CI) was 0.929 (0.683-1.264) and the multivariate-adjusted HR (95% CI) was 0.922 (0.620-1.372). In the matched cohort, the unadjusted HR (95% CI) was 0.930 (0.616-1.402) and the multivariate-adjusted HR (95% CI) was 0.825 (0.498-1.367). None of the analyses conducted for cumulative duration and cumulative dose was significant, either being treated as tertile cutoffs or as continuous variables, in either the unmatched cohort or the matched cohort.ConclusionsThis study showed a neutral effect of vildagliptin on dementia risk.

scholarly journals Metformin and Risk of Malignant Brain Tumors in Patients with Type 2 Diabetes Mellitus

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1226 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Brain Tumors ◽  
Risk Reduction ◽  
Malignant Brain Tumors ◽  
Hazard Ratios ◽  
Cumulative Duration

The risk of malignant brain tumors associated with metformin use has rarely been investigated in humans. This retrospective cohort study investigated such an association. Patients with new-onset type 2 diabetes mellitus diagnosed from 1999 to 2005 in the nationwide database of Taiwan’s national health insurance were used to enroll study subjects. We first identified an unmatched cohort of 153,429 ever users and 16,222 never users of metformin. A cohort of 16,222 ever users and 16,222 never users matched on propensity score was then created from this unmatched cohort. All patients were followed up from 1 January 2006 until 31 December 2011. The incidence density was calculated and hazard ratios were derived from Cox regression incorporated with the inverse probability of treatment weighting using a propensity score. The results showed that 27 never users and 155 ever users developed malignant brain tumors in the unmatched cohort. The incidence rate was 37.11 per 100,000 person-years in never users and 21.39 per 100,000 person-years in ever users. The overall hazard ratio comparing ever users versus never users was 0.574 (95% confidence interval: 0.381–0.863). The respective hazard ratios comparing the first (<27.13 months), second (27.13–58.33 months), and third (>58.33 months) tertiles of cumulative duration of metformin therapy versus never users were 0.897 (0.567–1.421), 0.623 (0.395–0.984), and 0.316 (0.192–0.518). In the matched cohort, the overall hazard ratio was 0.317 (0.149–0.673) and the respective hazard ratios were 0.427 (0.129–1.412), 0.509 (0.196–1.322), and 0.087 (0.012–0.639) for the first, second, and third tertile of cumulative duration of metformin therapy. In conclusion, this study shows a risk reduction of malignant brain tumors associated with metformin use in a dose–response pattern. The risk reduction is more remarkable when metformin has been used for approximately 2–5 years.

scholarly journals Metformin Use is Associated with A Lower Incidence of Hospitalization for Atrial Fibrillation in Patients with Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Sensitivity Analyses ◽  
Matched Cohort ◽  
Hazard Ratios ◽  
Incidence Of Hospitalization

Abstract Background: The effect of metformin on the risk of atrial fibrillation (AF) requires confirmation. This study compared the incidence of hospitalization for AF in ever and never users of metformin. Methods: Patients with newly diagnosed type 2 diabetes mellitus during 1999-2005 were enrolled from Taiwan’s National Health Insurance database. Analyses were conducted in both an unmatched cohort of 173398 ever users and 21666 never users and in a propensity score-matched cohort of 21647 pairs of ever and never users. They were free from a diagnosis of AF before January 1, 2006 and were followed up until December 31, 2011. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using the propensity score.Results: A total of 303 ever users and 86 never users in the unmatched cohort and 50 ever users and 86 never users in the matched cohort developed hospitalization for AF during follow-up. The respective incidence rates were 37.72 and 92.45 per 100,000 person-years in the unmatched cohort and were 50.71 and 92.52 per 100,000 person-years in the matched cohort. The hazard ratio for ever versus never users was 0.405 (95% confidence interval: 0.319-0.515) in the unmatched cohort and 0.548 (0.387-0.777) in the matched cohort. Hazard ratios for the tertiles of cumulative duration of metformin therapy versus never users showed a dose-response effect. The findings were consistent in sensitivity analyses.Conclusion: Metformin use is associated with a lower risk of hospitalization for AF in patients with type 2 diabetes mellitus.

scholarly journals Metformin Use Is Associated With a Lower Incidence of Hospitalization for Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus

2021 ◽  
Vol 7 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Sensitivity Analyses ◽  
Matched Cohort ◽  
Hazard Ratios ◽  
Incidence Of Hospitalization

Background: The effect of metformin on the risk of atrial fibrillation (AF) requires confirmation. This retrospective cohort study compared the incidence of hospitalization for AF in ever and never users of metformin.Methods: Patients with newly diagnosed type 2 diabetes mellitus during 1999–2005 were enrolled from Taiwan's National Health Insurance database. Analyses were conducted in both an unmatched cohort of 173,398 ever users and 21,666 never users and in a propensity score-matched cohort of 21,662 pairs of ever and never users. They were free from a diagnosis of AF before January 1, 2006 and were followed up until December 31, 2011. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using the propensity score.Results: A total of 303 ever users and 86 never users in the unmatched cohort and 56 ever users and 86 never users in the matched cohort developed hospitalization for AF during follow-up. The respective incidence rates were 37.72 and 92.45 per 100,000 person-years in the unmatched cohort and were 56.98 and 92.46 per 100,000 person-years in the matched cohort. The hazard ratio for ever vs. never users was 0.405 (95% confidence interval: 0.319–0.515) in the unmatched cohort and 0.617 (0.441–0.864) in the matched cohort. Hazard ratios for the tertiles of cumulative duration of metformin therapy vs. never users showed a dose-response effect. The findings were consistent in sensitivity analyses.Conclusion: Metformin use is associated with a lower risk of hospitalization for AF in patients with type 2 diabetes mellitus.

scholarly journals On the survival of individuals diagnosed with type 2 diabetes mellitus in the United Kingdom: a retrospective matched cohort study

2021 ◽  
Author(s):  
Njabulo Ncube ◽  
Elena Kulinskaya ◽  
Nicholas Steel ◽  
Dmitry Pchejetski
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Birth Cohort ◽  
Matched Cohort ◽  
Birth Cohorts ◽  
All Cause Mortality

Objective To estimate long-term hazards of all-cause mortality following a diagnosis of type 2 diabetes mellitus (T2DM) using electronic primary care data. Methodology Retrospective matched cohort study using electronic health records from THIN primary care database. The study included individuals born between 1930 and 1960, diagnosed with T2DM between 2000 and 2016 and aged 50-74 years and excluded those with pre-existing stroke, cancer, cognitive impairment, lower limb amputation or chronic kidney disease (CKD) stages 3 to 5. T2DM individuals were matched at diagnosis to at most 3 controls by age, gender and general practice (GP) and followed up to 1 January 2017. Time-varying hazards of all-cause mortality were then estimated using Gompertz-double-Cox model with frailty on GP, adjusting for medical history, socio-demographic and lifestyle factors. Results A total of 221 182 (57.6% Males, 30.8% T2DM) individuals were selected for the study of whom 29 618 (13.4%) died during follow-up. The adjusted mortality hazard of type 2 diabetes mellitus (T2DM) was estimated to be 1.21[1.12-1.3] and 1.52[1.44-1.6] among individuals diagnosed at 50-59 years and 60-74 years, respectively, compared to controls. Deprivation, obesity, smoking and comorbidities affected survival of cases and controls equally. Compared to the 1930-39 birth cohort, all-cause mortality hazards were reduced in the 1940-49 cohort, but increased at older ages in the 1950-60 birth cohort for both cases and controls. Conclusion T2DM is associated with raised all-cause mortality hazards which increase with age of diagnosis. These hazards associated with age at diagnosis are constant across all birth cohorts demonstrating a lack of progress over time in reducing the relative risks of all-cause mortality associated with T2DM. A further study that includes people born after 1960 is needed to fully understand the emerging higher mortality hazards among the younger birth cohorts.

scholarly journals Chronic Metformin Therapy is Associated with a Lower Risk of Hemorrhoid in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 11 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Risk ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Matched Cohort ◽  
Metformin Therapy ◽  
New Onset

Background: Metformin has anti-inflammatory property and reduces the risk of varicose vein in our previous study.Aim: To investigate the risk of hemorrhoid, another common disease involving the hemorrhoidal venous plexus, in ever vs. never users of metformin in patients with type 2 diabetes mellitus.Methods: This is a population-based retrospective cohort study. Patients with new-onset type 2 diabetes mellitus during 1999–2005 were enrolled from Taiwan’s National Health Insurance. All patients who were alive on January 1, 2006 were followed up until December 31, 2011. Analyses were conducted in both an unmatched cohort of 152,347 ever users and 19,523 never users and in 19,498 propensity score (PS)-matched pairs of ever and never users. Traditional Cox regression and Cox regression incorporated with the inverse probability of treatment weighting (IPTW) using the PS were used to estimate hazard ratios.Results: New-onset hemorrhoid was diagnosed in 8,211 ever users and 2025 never users in the unmatched cohort and in 1,089 ever users and 2022 never users in the matched cohort. The hazard ratio for ever vs. never users derived from the traditional Cox regression was 0.464 (95% confidence interval: 0.440–0.488) in the unmatched cohort; and was 0.488 (0.453–0.525) in the matched cohort. In the IPTW models, the hazard ratio was 0.464 (0.442–0.487) in the unmatched cohort and was 0.492 (0.457–0.530) in the matched cohort. A dose-response pattern was observed while comparing the tertiles of cumulative duration, cumulative dose and defined daily dose of metformin therapy to never users in all analyses. A risk reduction of approximately 40–50% was consistently observed in various sensitivity analyses.Conclusion: Chronic therapy with metformin in patients with type 2 diabetes mellitus is associated with a lower risk of hemorrhoid.

Human insulin to increase breast cancer risk in Taiwanese women with type 2 diabetes.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 26-26
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Breast Cancer ◽  
Type 2 Diabetes ◽  
Human Insulin ◽  
Cumulative Dose ◽  
Breast Cancer Incidence ◽  
Diabetic Patients ◽  
Hazard Ratios ◽  
Taiwanese Women ◽  
Cumulative Duration

26 Background: To investigate whether human insulin use may be associated with risk of breast cancer in Taiwanese women with type 2 diabetes. Methods: The reimbursement databases of all Taiwanese diabetic patients from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2004 and a total of 482,065 women with type 2 diabetes were followed up for breast cancer incidence until the end of 2009. Incidences for ever-users, never-users and subgroups of human insulin exposure (using tertile cutoffs of time since starting insulin, cumulative dose and cumulative duration of insulin) were calculated and the multivariable-adjusted hazard ratios were estimated by Cox regression. Results: There were 59,830 ever-users and 422,235 never-users, with respective numbers of incident breast cancer of 559 (0.93%) and 4,711 (1.12%), and respective incidence of 207.7 and 215.1 per 100,000 person-years. The overall adjusted hazard ratios (95% confidence intervals) did not show a significant association with insulin [1.098 (0.994-1.212)]. However, significant trends for the different categories of the dose-responsive parameters were observed. Patients in the third tertiles consistently showed a significantly higher risk of breast cancer while compared to never-users: 1.263 (1.093-1.458), 1.339 (1.164-1.540) and 1.331 (1.158-1.531) for ≥ 67 months for time since starting insulin, ≥ 39,000 units for cumulative dose of insulin, and ≥ 21.8 months for cumulative duration of insulin, respectively. Conclusions: This study discloses a significantly higher risk of breast cancer associated with the use of human insulin, demonstrating a significant dose-responsive relationship.

Patients with Type 2 diabetes mellitus have a worse functional outcome post knee arthroplasty: A matched cohort study

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 286-289 ◽  
Author(s):  
Francis Robertson ◽  
Jacqueline Geddes ◽  
David Ridley ◽  
Gordon McLeod ◽  
Kenneth Cheng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Matched Cohort ◽  
Matched Cohort Study
Sign in / Sign up

Export Citation Format

Share Document