Sulfonylurea Use in Patients with Type 2 Diabetes and COPD: A Nationwide Population-Based Cohort Study

Int J Environ Res Public Health. 2022 Nov 15;19(22):15013. doi: 10.3390/ijerph192215013.

Abstract

We conducted this study to investigate the long-term outcomes of sulfonylurea (SU) use in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2D). We used propensity-score matching to identify 6008 pairs of SU users and nonusers from Taiwan's National Health Insurance Research Database from 1 January 2000 to 31 December 2017. Cox proportional hazard models were used to compare the risks of mortality, cardiovascular events, non-invasive positive pressure ventilation, invasive mechanical ventilation, bacterial pneumonia, lung cancer, and hypoglycemia between SU users and nonusers. In the matched cohorts, the mean follow-up time for SU users and nonusers was 6.57 and 5.48 years, respectively. Compared with nonusers, SU users showed significantly lower risks of mortality [aHR 0.53(0.48-0.58)], cardiovascular events [aHR 0.88(0.81-0.96)], non-invasive positive pressure ventilation [aHR 0.74(0.6-0.92)], invasive mechanical ventilation [aHR 0.57(0.5-0.66)], and bacterial pneumonia [aHR 0.78(0.7-0.87)]. A longer cumulative duration of SU use was associated with a lower risk of these outcomes. This nationwide cohort study demonstrated that SU use was associated with significantly lower risks of cardiovascular events, ventilation use, bacterial pneumonia, and mortality in patients with COPD and T2D. SU may be a suitable option for diabetes management in these patients.

Keywords: all-cause mortality; bacterial pneumonia; invasive mechanical ventilation; lung cancer; major adverse cardiovascular events; non-invasive positive pressure ventilation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases* / complications
  • Cohort Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Humans
  • Pulmonary Disease, Chronic Obstructive* / complications
  • Pulmonary Disease, Chronic Obstructive* / drug therapy
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Retrospective Studies
  • Sulfonylurea Compounds / therapeutic use

Substances

  • Sulfonylurea Compounds

Grants and funding

This study was supported in part by the Ministry of Health and Welfare Clinical Trial Center, Taiwan (MOHW109-TDU-B-212-114004), MOST Clinical Trial Consortium for Stroke (MOST 109-2321-B-039-002), China Medical University Hospital (DMR-110-222), Tseng-Lien Lin Foundation, Taichung, Taiwan. These funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The writing or preparation of this paper was not funded by any organization; the data analyses were not undertaken by individuals who are employees of funders, or any author who received funding from funders; and no writing support was provided by the funders. The corresponding authors had complete access to all data in the study and were responsible for the decision to submit this manuscript for publication.