Introduction
Methods
Data Source, Study Design, and Study Sample Selection
Study Measures
Demographic and Clinical Characteristics
Hypoglycemia Events and Costs
Statistical Analyses
Results
Patient Characteristics
Characteristic | Sulfonylureas (N = 245,201) | Dipeptidyl peptidase-4 inhibitors (N = 176,786) |
---|---|---|
Mean (SD) age, years | 51.9 (8.9) | 52.8 (8.3) |
Female, % | 43.5 | 45.5 |
Geographic region, % | ||
Northeast | 9.9 | 12.1 |
Midwest | 24.1 | 22.3 |
West | 47.6 | 52.1 |
South | 17.6 | 12.8 |
Mean (SD) Charlson comorbidity index | 1.5 (1.3) | 1.6 (1.2) |
Comorbid conditions, % | ||
Hypertension | 53.3 | 57.5 |
Hyperlipidemia | 48.4 | 56.5 |
Obesity or overweight | 9.1 | 8.6 |
Cataracts, macular edema, retinopathy, or blindness | 8.0 | 10.0 |
Neuropathy | 7.4 | 8.5 |
Depression | 6.5 | 6.3 |
Chronic obstructive pulmonary disease | 5.5 | 5.0 |
Cancer | 4.3 | 4.3 |
Chronic kidney diseases or nephropathy | 3.8 | 4.0 |
Hypoglycemia | 2.3 | 2.0 |
Proteinuria | 2.2 | 2.4 |
Fracture | 1.9 | 1.9 |
Sleep disorder | 1.6 | 1.8 |
HIV/AIDS | 0.2 | 0.2 |
Alzheimer’s disease, dementia, or MCI | 0.1 | 0.1 |
Cardiovascular disease, % | ||
Arrhythmia | 4.5 | 4.4 |
Cerebrovascular disease | 3.2 | 3.4 |
Congestive heart failure | 3.1 | 2.8 |
Peripheral arterial disease | 2.7 | 3.2 |
Stroke/transient ischemic attacks | 2.6 | 2.8 |
Myocardial infarction | 1.7 | 1.3 |
Angina pectoris | 1.6 | 1.8 |
Use of antihyperglycemic medications, % | ||
Metformin | 61.1 | 68.8 |
Thiazolidinediones | 13.1 | 25.1 |
Dipeptidyl peptidase-4 inhibitors | 4.8 | 0.0 |
Meglitinides | 0.9 | 1.9 |
Alpha-glucosidase inhibitors | 0.1 | 0.3 |
Sulfonylureas | 0.0 | 16.9 |
Use of antihypertensive medications, % | 58.5 | 65.3 |
Use of antihyperlipidemic medications, % | 47.8 | 58.9 |
Hypoglycemia Event Rates and Costs
2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | |
---|---|---|---|---|---|---|---|
Hypoglycemia event rate per 100 patient-years | |||||||
Sulfonylureas | 5.4 | 6.7 | 8.1 | 8.2 | 7.5 | 9.0 | 10.4 |
Dipeptidyl peptidase-4 inhibitors | 3.2 | 3.0 | 3.2 | 3.6 | 4.3 | 4.3 | 6.4 |
Mean cost per hypoglycemia event, $ | |||||||
Sulfonylureas | 565 | 1168 | 1035 | 880 | 931 | 1098 | 1154 |
Dipeptidyl peptidase-4 inhibitors | 308 | 514 | 915 | 410 | 365 | 477 | 482 |