Relationship between the efficacy of oral antidiabetic drugs and clinical features in type 2 diabetic patients (JDDM38)

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Abstract

Aims/Introduction:

We carried out an observational cohort study to examine the relationship between the efficacy of oral antidiabetic drugs and clinical features in type 2 diabetics.

Materials and Methods:

We analyzed the CoDiC® database of the Japan Diabetes Data Management Study Group across 67 institutions in Japan. In a total of 3,698 drug-naïve patients who were initiated with metformin, dipeptidyl peptidase-4 inhibitor (DPP-4i) or sulfonylurea (SU) from 2007 to 2012, we evaluated body mass index (BMI) and hemoglobin A1c (HbA1c). The patients were stratified according to their clinical features, and matched using a propensity score to adjust for baseline factors.

Results:

HbA1c was reduced with all drugs, with the largest effect elicited by DPP-4i and the smallest by SU (P = 0.00). HbA1c increased with SU after 6 months in the patients stratified by an age-of-onset of <50 years (P = 0.00). BMI increased with SU in the patients stratified by a BMI of <25 (P = 0.00), and decreased with metformin in the patients with a BMI >25 (P = 0.00). The reduction in HbA1c was larger in patients with HbA1c of ≥8%, compared with that in patients with HbA1c of <8% (P = 0.00). HbA1c during the study period was higher in patients who were added to or swapped with other drug(s), than in patients continued on the original drug (P = 0.00).

Conclusions:

The effect on bodyweight and glycemic control differed among metformin, DPP-4i and SU, and the difference was associated with clinical features.

We performed an observational cohort study to examine the relationship between efficacy of oral anti-diabetic drugs and clinical features in type 2 diabetics, using CoDiC® database of the Japan Diabetes Data Management Study Group in Japan and a propensity score-matching method to minimize or eliminate both selection biases and confounding effects related to diabetes treatment selection. We concluded that the effect on body weight and glycemic control differed among metformin, DPP-4inhibitor, and sulfonylurea, and the difference was associated with clinical features.

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