Sulfonylureas may be useful for glycemic management in patients with diabetes and liver cirrhosis

PLoS One. 2020 Dec 14;15(12):e0243783. doi: 10.1371/journal.pone.0243783. eCollection 2020.

Abstract

This study aimed to investigate the long-term outcomes of sulfonylurea (SU) use in patients with T2DM and compensated liver cirrhosis. From January 1, 2000, to December 31, 2012, we selected the data of 3781 propensity-score-matched SU users and nonusers from Taiwan's National Health Insurance Research Database. The mean follow-up time for this study was 5.74 years. Cox proportional hazards models with robust sandwich standard error estimates were used to compare the risks of main outcomes between SU users and nonusers. The incidence of mortality during follow-up was 3.24 and 4.09 per 100 person-years for SU users and nonusers, respectively. The adjusted hazard ratios and 95% confidence intervals for all-cause mortality, major cardiovascular events, and decompensated cirrhosis in SU users relative to SU nonusers were 0.79 (0.71-0.88), 0.69 (0.61-0.80), and 0.82 (0.66-1.03), respectively. The SU-associated lower risks of death and cardiovascular events seemed to have a dose-response trend. This population-based cohort study demonstrated that SU use was associated with lower risks of death and major cardiovascular events compared with SU non-use in patients with T2DM and compensated liver cirrhosis. SUs may be useful for glycemic management for patients with liver cirrhosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / mortality
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Incidence
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / mortality
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Propensity Score
  • Proportional Hazards Models
  • Risk Factors
  • Sulfonylurea Compounds / adverse effects
  • Sulfonylurea Compounds / therapeutic use*
  • Young Adult

Substances

  • Hypoglycemic Agents
  • Sulfonylurea Compounds

Grants and funding

This study is supported in part by Taiwan’s Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), Ministry of Science and Technology Clinical Trial Consortium for Stroke (MOST 108-2321-B-039-003), Tseng-Lien Lin Foundation, Taichung, Taiwan (URL of each funder website: https://www.taiwanclinicaltrials.tw/ctc; http://www.ltl-charity.org.tw/about.php?id=4). These funding agencies did not influence the study design, data collection and analysis, decision to publish, or manuscript preparation. The writing and preparation of this paper was not funded by any organization, and employees of funders or any author who received the funding did not undertake data analysis. The funders did not offer support for writing. The corresponding authors had complete access to all data in the study and final responsibility for the publication decision. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.