Toulis, K A., Hanif, W., Saravanan, P., Willis, B. H., Marshall, T., Kumarendran, B., Gokhale, K., Ghosh, S., Cheng, K. K., Narendran, P., Thomas, G. N. and Nirantharakumar, K. (2017) All-cause mortality in patients with diabetes under glucagon-like peptide-1 agonists : a population-based, open cohort study. Diabetes & Metabolism, 43 (3). pp. 211-216. doi:10.1016/j.diabet.2017.02.003 ISSN 1878-1780.
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Abstract
The glucagon-like peptide-1 receptor agonist (GLP1a) liraglutide has been described to benefit patients with type 2 diabetes mellitus (T2DM) at high cardiovascular risk. However, there are still uncertainties relating to these cardiovascular benefits: whether they also apply to an unselected diabetic population that includes low-risk patients, represent a class-effect, and could be observed in a real-world setting. We conducted a population-based, retrospective open cohort study using data derived from The Health Improvement Network database between Jan 2008 to Sept 2015. Patients with T2DM exposed to GLP1a (n=8345) were compared to age, gender, body mass index, duration of T2DM and smoking status-matched patients with T2DM unexposed to GLP1a (n=16,541). Patients with diabetes receiving GLP1a were significantly less likely to die from any cause compared to matched control patients with diabetes (adjusted incidence rate ratio [aIRR]: 0.64, 95% CI: 0.56-0.74, P-value<0.0001). Similar findings were observed in low-risk patients (aIRR: 0.64, 95% CI: 0.53-0.76, P -value=0.0001). No significant difference in the risk of incident CVD was detected in the low-risk patients (aIRR: 0.93, 95% CI: 0.83-1.12). Subgroup analyses suggested that effect is persistent in the elderly or across glycated haemoglobin categories. GLP1a treatment in a real-world setting may confer additional mortality benefit in patients with T2DM irrespective of their baseline CVD risk, age or baseline glycated haemoglobin and was sustained over the observation period.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RC Internal medicine |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| SWORD Depositor: | Library Publications Router |
| Library of Congress Subject Headings (LCSH): | Non-insulin-dependent diabetes -- Treatment -- Risk factors, Cardiovascular system -- Diseases |
| Journal or Publication Title: | Diabetes & Metabolism |
| Publisher: | Elsevier Masson |
| ISSN: | 1878-1780 |
| Official Date: | June 2017 |
| Dates: | Date Event June 2017 Published 18 March 2017 Available 7 February 2017 Accepted |
| Volume: | 43 |
| Number: | 3 |
| Page Range: | pp. 211-216 |
| DOI: | 10.1016/j.diabet.2017.02.003 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Date of first compliant deposit: | 5 June 2018 |
| RIOXX Funder/Project Grant: | Project/Grant ID RIOXX Funder Name Funder ID 201508030037 Guangzhou Science and Technology Bureau UNSPECIFIED |
| URI: | https://wrap.warwick.ac.uk/87396/ |
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