Metformin, sulfonylureas, or other antidiabetes drugs and the risk of lactic acidosis or hypoglycemia: a nested case-control analysis.
Metformin, sulfonylureas, or other antidiabetes drugs and the risk of lactic acidosis or hypoglycemia: a nested case-control analysis.
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二甲双胍，磺酰脲或其他抗糖尿病药物以及乳酸性酸中毒或低血糖的风险：嵌套的病例对照分析。
DOI：
10.2337/dc08-1171
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发表时间：
2008-11
期刊：
影响因子：
16.2
通讯作者：
Meier, Christoph R.
中科院分区：
文献类型：
--
作者：
Bodmer, Michael;Meier, Christian;Kraehenbuehl, Stephan;Jick, Susan S.;Meier, Christoph R.
目的：乳酸酸中毒与二甲双胍的使用有关。低血糖是使用磺脲类药物的主要问题。本研究的目的是比较使用口服降糖药的2型糖尿病患者发生乳酸酸中毒和低血糖的风险。研究设计和方法：本研究采用嵌套病例对照分析，使用英国全科医学研究数据库来确定使用口服降糖药的2型糖尿病患者。在研究人群中，所有乳酸酸中毒和低血糖的病例都被确定，低血糖病例受试者根据年龄、性别、实践和日历时间与多达4名对照患者相匹配。结果：在50048名2型糖尿病患者的研究人群中，在目前使用口服降糖药期间发现了6例乳酸性酸中毒，二甲双胍使用者的粗发病率为3.3例/ 10万人年，磺脲类药物使用者的粗发病率为4.8例/ 10万人年。相关的合并症被称为乳酸酸中毒的危险因素，可以在所有病例中确定。共确定了2025例低血糖患者和7278例匹配的对照组。磺脲类药物的使用与低血糖风险显著升高相关。与目前使用的二甲双胍相比，目前使用磺脲类药物的调整优势比为2.79 （95% CI 2.23-3.50）。结论：目前口服降糖药使用过程中的乳酸性酸中毒非常罕见，并伴有并发症。低血糖发作在磺脲类药物使用者中比在二甲双胍使用者中更为常见。
OBJECTIVE—Lactic acidosis has been associated with use of metformin. Hypoglycemia is a major concern using sulfonylureas. The aim of this study was to compare the risk of lactic acidosis and hypoglycemia among patients with type 2 diabetes using oral antidiabetes drugs. RESEARCH DESIGN AND METHODS—This study is a nested case-control analysis using the U.K.-based General Practice Research Database to identify patients with type 2 diabetes who used oral antidiabetes drugs. Within the study population, all incident cases of lactic acidosis and hypoglycemia were identified, and hypoglycemia case subjects were matched to up to four control patients based on age, sex, practice, and calendar time. RESULTS—Among the study population of 50,048 type 2 diabetic subjects, six cases of lactic acidosis during current use of oral antidiabetes drugs were identified, yielding a crude incidence rate of 3.3 cases per 100,000 person-years among metformin users and 4.8 cases per 100,000 person-years among users of sulfonylureas. Relevant comorbidities known as risk factors for lactic acidosis could be identified in all case subjects. A total of 2,025 case subjects with hypoglycemia and 7,278 matched control subjects were identified. Use of sulfonylureas was associated with a materially elevated risk of hypoglycemia. The adjusted odds ratio for current use of sulfonylureas was 2.79 (95% CI 2.23–3.50) compared with current metformin use. CONCLUSIONS—Lactic acidosis during current use of oral antidiabetes drugs was very rare and was associated with concurrent comorbidity. Hypoglycemic episodes were substantially more common among sulfonylurea users than among users of metformin.
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影响因子：
168.9
作者：
Turner, RC;Holman, RR;Ward, JD
通讯作者：
Ward, JD
影响因子：
16.2
作者：
Brown, JB;Pedula, K;Latare, P
通讯作者：
Latare, P
影响因子：
--
作者：
Miller, CD;Phillips, LS;El-Kebbi, IM
通讯作者：
El-Kebbi, IM
影响因子：
16.2
作者：
Stang, M;Wysowski, DK;Butler-Jones, D
通讯作者：
Butler-Jones, D
影响因子：
4.2
作者：
Wood, L;Martinez, C
通讯作者：
Martinez, C