Abstract:
OBJECTIVE:Healthcare providers managing older patients with type 2 diabetes mellitus (T2DM) face a complex milieu of medical conditions and comorbidities, which increase the risk of unintended treatment consequences. The objective of this study was to understand factors associated with hypoglycemia-related hospitalizations among adults with T2DM with an emphasis on older patients. RESEARCH DESIGN AND METHODS:A large retrospective cohort study using claims data from the United States was undertaken identifying actively registered patients diagnosed with T2DM and at least one diabetes medication prescription. MAIN OUTCOME MEASURES:The main outcomes included hypoglycemia-related hospitalization and frequency of comorbidities. RESULTS:Of patients with T2DM and hospitalization records (n = 887,182), 52.3% were male and 30.7% were aged ≥65 years. At baseline, the proportion of patients taking metformin was 52.4%, insulin 7.3%, and sulfonylurea 26.4%. Among those with diabetes-related hospitalizations, the incidence of hospitalization-related hypoglycemia in patients ≥65 years of age was greater than in patients <65 years of age (0.59 compared to 0.16 per 1000 person years). Using boosted regression tree modeling, age (older vs. younger), sulfonylurea use, insulin use, and renal disease were variables most associated with predicting hospitalizations associated with hypoglycemia. Elderly patients prescribed both insulin and sulfonylurea were most likely to experience hypoglycemia-related hospitalizations (odds ratio = 4.7; 95% CI 3.7-6.1). CONCLUSIONS:Older patients using both insulin and sulfonylurea were most likely to experience a hypoglycemia-related hospitalization. Age, sulfonylurea use, insulin use, renal disease, a history of hypoglycemia-related hospitalization and general hospitalization were the leading variables associated with hypoglycemia-related hospitalization. Glucagon-like peptide and dipeptidyl peptidase-4 medication use was not significantly associated with hypoglycemia-related hospitalizations. The strength of this analysis, compared to similar studies, lies in the large and generalizable sample size and statistical methodology, which control for the interdependence of predictive variables. Limitations include lack of information, such as dietary intake and exercise habits, which are known to influence the rate of hypoglycemia in certain patients. Given the frequency of use of insulin and sulfonylurea in a population at risk for hypoglycemia (older patients with diabetes), care should be taken when balancing cost and efficacy against safety and increased risk of hospitalization due to hypoglycemia.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Fu H,Xie W,Curtis B,Schuster Ddoi
10.1185/03007995.2014.922944subject
Has Abstractpub_date
2014-09-01 00:00:00pages
1787-93issue
9eissn
0300-7995issn
1473-4877journal_volume
30pub_type
杂志文章abstract::Filgrastim prophylaxis, both primary and secondary, was rapidly incorporated into clinical practice in the 1990s. When pegfilgrastim became available in 2002, it quickly replaced filgrastim as the colony-stimulating factor (CSF) of choice for prophylaxis. Use of prophylaxis increased markedly in the first decade of th...
journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1080/03007995.2019.1703665
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To investigate the predictive factors associated with physical impairment among older patients with type 2 diabetes mellitus (T2DM) in Japan and to examine the potential impact of physical impairment on patient-reported health outcomes in this population. METHODS:A cross-sectional analysis was conducted usin...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2020.1846170
更新日期:2020-11-23 00:00:00
abstract:PURPOSE:Tamoxifen, used in breast cancer treatment, may induce hepatic steatosis. It has been suggested that leptin, which has a relationship with body fat stores, may be involved in the pathogenesis of hepatic steatosis. In this study, we compared serum leptin levels in tamoxifen-treated patients with and without hepa...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079902125001308
更新日期:2003-01-01 00:00:00
abstract::In a single-blind study in general practice, 60 patients with anxiety neuroses were randomly allocated to receive either 0.5 mg haloperidol twice daily or 2 mg diazepam 3-times daily for 6 weeks. Eighteen patients (6 on haloperidol and 12 on diazepam) were excluded from the analysis of efficacy. On the Hamilton Rating...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007997909109010
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVE:Parenteral sodium ferric gluconate in complex (Ferrlecit [branded SFG]) is used to treat patients with iron deficiency anemia undergoing chronic hemodialysis and receiving supplemental epoetin. This comparative pharmacokinetic study (GeneraMedix, Inc., Study 17909) evaluates whether the recently approved gene...
journal_title:Current medical research and opinion
pub_type: 杂志文章,随机对照试验
doi:10.1185/03007995.2011.597738
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:Tumor hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expression are important factors influencing treatment response and selection in patients with metastatic breast cancer (mBC). Using the LifeLink Oncology Analyzer Database, we classified mBC patients by combined HR and HER2 st...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2012.694364
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Most patients with hypertension require antihypertensive combination therapy to achieve BP control. This study investigated the safety and efficacy of the direct renin inhibitor aliskiren combined with the calcium channel blocker amlodipine. METHODS:Overall, 556 patients with hypertension (msDBP > or =95-<11...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007990902785845
更新日期:2009-04-01 00:00:00
abstract::An open, parallel-group study was carried out to compare the efficacy and tolerance of a sustained-release capsule formulation of tiaprofenic acid at a dosage of 600 mg once daily with standard 300 mg tiaprofenic acid tablets given twice daily. Four hundred and eighty-five general practice patients with rheumatic dise...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1185/03007998709112408
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to quantify the incidence of thromboembolic events (specifically, deep vein thromboses [DVT] and pulmonary embolism [PE]) in patients with cancer, and to examine the effects of a major clinical trial design and execution factors on those incidence rates. RESEARCH DESIGN AND ME...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/030079908x261050
更新日期:2008-02-01 00:00:00
abstract::A clinical study was carried out to evaluate the usefulness of intravenous lorazepam, given for sedation instead of opiate narcotics or diazepam, in 25 seriously-ill patients being treated in a respiratory and intensive care unit. All but 3 patients were on assisted ventilation. Standard doses of 4 mg lorazepam were g...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007997609109320
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of intranasal fentanyl spray (INFS), oral transmucosal fentanyl citrate (OTFC), fentanyl buccal tablet (FBT) and oral morphine (OM) for the treatment of breakthrough cancer pain (BTCP). METHODS:A systematic literature review (Medline, EMBASE, BIOSIS; 1996-2007) identified six randomis...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/03007991003694340
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the relative efficacy and safety of extended-release tramadol HCl 75 mg/acetaminophen 650 mg (TA-ER) and immediate-release tramadol HCl 37.5 mg/acetaminophen 325 mg (TA-IR) for the treatment of moderate to severe acute pain following total knee replacement. METHODS:This phase III, double-blind, p...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2014.975338
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:A double-blind randomized trial evaluated the efficacy and tolerability of rivastigmine and donepezil in patients with Alzheimer's disease (AD) over 2 years. Baseline data indicated that some patients had symptoms suggestive of concomitant Lewy body disease. This retrospective analysis investigated whether A...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/030079906x80279
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Aliskiren is the first in a new class of orally effective direct renin inhibitors approved for the treatment of hypertension. This multiple-dose study investigated the potential for pharmacokinetic interactions between aliskiren and three drugs, each predominantly eliminated by a different clearance/metabolic...
journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
doi:10.1185/030079908X260934
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of antiresorptive agents in reducing the risk of vertebral and non-vertebral fractures using data from published meta-analyses and the technique of adjusted indirect comparisons. RESEARCH DESIGN AND METHODS:Pairs of agents were compared by adjusted indirect comparison of 0.56 [0....
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079904125003269
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:It has been acknowledged that patients who receive a beta-blocker or diuretic based regimen are at increased risk of developing new-onset diabetes. Recently, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to decrease patients' odds of developing new-o...
journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析
doi:10.1185/030079907X188044
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Hyperuricaemia is associated with indapamide administration. In contrast, micronised fenofibrate can significantly decrease serum uric acid levels. However, there are no data on the effect of combination therapy of indapamide with micronised fenofibrate on uric acid metabolism. METHODS:We studied 20 non-diab...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079902125000273
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine how lifestyle behaviors in the context of physical activity levels and screen time are associated with school absenteeism. METHODS:We analyzed 2005-2008 NHANES data of proxy interviews for 1048 children aged 6-11 years and in-person self-reports of 1117 adolescents ag...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1135112
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1185/03007999009111497
更新日期:1990-01-01 00:00:00
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journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
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journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2016.1176014
更新日期:2016-06-01 00:00:00
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journal_title:Current medical research and opinion
pub_type: 杂志文章,meta分析,评审
doi:10.1185/03007995.2014.946127
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the safety and clinical efficacy of alcaftadine 0.25% ophthalmic solution, a new topical anti-allergic agent for the prevention of the signs and symptoms of allergic conjunctivitis induced by conjunctival allergen challenge (CAC). STUDY DESIGN AND METHODS:This two-ar...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1185/03007995.2010.548797
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to ascertain the factors associated with non-achievement of triglyceride (TG) goals in a cohort of hypertriglyceridemic patients attending the lipid clinics of the Spanish Arteriosclerosis Society (LC-SAS). METHODS:Patients with high TG levels (>2.2 mmol/L; 200 mg/dL) were included...
journal_title:Current medical research and opinion
pub_type: 杂志文章,多中心研究
doi:10.1185/03007995.2013.850069
更新日期:2014-01-01 00:00:00
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journal_title:Current medical research and opinion
pub_type: 杂志文章,评审
doi:10.1185/03007990903550586
更新日期:2010-03-01 00:00:00
abstract::Data from phase III clinical trials suggest that high dose chemotherapy (HDC) is currently not indicated for any stage of breast cancer. Therefore HDC should only be considered within the context of clinical trials. Furthermore, there is no significant evidence to support the routine use of taxanes in women with metas...
journal_title:Current medical research and opinion
pub_type:
doi:
更新日期:2001-01-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:The management of hyponatremia has evolved in recent years, particularly with the introduction of tolvaptan for hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This commentary presents a summary of recent international recommendations in the for...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/03007995.2015.1072706
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Clinical evidence supports the use of cardiac resynchronization therapy (CRT) in advanced heart failure, but its cost-effectiveness is still unclear. This analysis assessed the economic and health consequences in the UK of implanting a CRT in patients with NYHA class III-IV heart failure. METHODS:A discrete ...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079906X112516
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVES:Cardiovascular disease (CVD) is the leading cause of mortality worldwide. A high level of low-density lipoprotein cholesterol (LDL-C) is a major CVD risk factor. Guidelines recommend effective cholesterol management and set LDL-C goals, yet deficiencies exist in physician implementation of these recommendati...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1185/030079908x280491
更新日期:2008-05-01 00:00:00
abstract::Objectives: Asthma/chronic obstructive pulmonary disease (COPD) overlap (ACO) is a recently described phenomenon defined as the coexistence of both asthma and COPD. Both asthma and COPD are known to result in increased emergency department (ED) visits and hospitalizations, but it is unclear how the ACO population util...
journal_title:Current medical research and opinion
pub_type: 杂志文章
doi:10.1080/03007995.2019.1565531
更新日期:2019-07-01 00:00:00