S Cammarota1, D Bruzzese2, A L Catapano3, A Citarella1, L De Luca1, L Manzoli4, M Masulli5, E Menditto1, A Mezzetti6, S Riegler1, D Putignano1, E Tragni7, E Novellino1, G Riccardi8. 1. CIRFF, "Federico II" University of Naples, Italy. 2. Department of Preventive Medical Sciences, "Federico II" University of Naples, Italy. 3. SEFAP, Department of Pharmacological Sciences, University of Milan, Italy; Multimedica IRCCS, S.S. Giovanni, Italy. 4. Section of Hygiene, Epidemiology, Pharmacology and Legal Medicine, University of Chieti, and Regional Health Care Agency of Abruzzo, Italy. 5. Department of Clinical and Experimental Medicine, "Federico II" University of Naples, Italy. 6. Clinical Research Centre, "G. D'Annunzio" University Foundation, Chieti, Italy. 7. SEFAP, Department of Pharmacological Sciences, University of Milan, Italy. 8. Department of Clinical and Experimental Medicine, "Federico II" University of Naples, Italy. Electronic address: riccardi@unina.it.
Abstract
BACKGROUND AND AIM: The aim of this study was to compare the use of insulin glargine and intermediate/long-acting human insulin (HI) in relation to the incidence of complications in diabetic patients. METHODS AND RESULTS: A population-based cohort study was conducted using administrative data from four local health authorities in the Abruzzo Region (900,000 inhabitants). Diabetic patients without macrovascular diseases and treated with either intermediate/long-acting HI or glargine were followed for 3-years; the incidence of diabetic (macrovascular, microvascular and metabolic) complications was ascertained by hospital discharge claims and estimated using Cox proportional hazard models. Propensity score (PS) matching was also used to adjust for significant differences in the baseline characteristics between the two groups. RESULTS: Overall, 1921 diabetic patients were included: 744 intermediate/long-acting HI and 1177 glargine users. During the 3-year follow-up, 209 (28.1%) incident events of any diabetic complication occurred in the intermediate/long-acting HI and 159 (13.5%) in the glargine group. After adjustment for covariates, glargine users had an HR (95% CI) of 0.57 (0.44-0.74) for any diabetic complication and HRs of 0.61 (0.44-0.84), 0.58 (0.33-1.04) and 0.35 (0.18-0.70) for macrovascular, microvascular and metabolic complications, respectively, compared to intermediate/long-acting HI users. PS analyses supported these findings. CONCLUSIONS: The use of glargine is associated with a lower risk of macrovascular complications compared with traditional basal insulins. However, limitations inherent to the study design including the short length of observation and the lack of data on metabolic control or diabetes duration, do not allow us to consider this association as a proof of causality.
BACKGROUND AND AIM: The aim of this study was to compare the use of insulinglargine and intermediate/long-acting humaninsulin (HI) in relation to the incidence of complications in diabeticpatients. METHODS AND RESULTS: A population-based cohort study was conducted using administrative data from four local health authorities in the Abruzzo Region (900,000 inhabitants). Diabeticpatients without macrovascular diseases and treated with either intermediate/long-acting HI or glargine were followed for 3-years; the incidence of diabetic (macrovascular, microvascular and metabolic) complications was ascertained by hospital discharge claims and estimated using Cox proportional hazard models. Propensity score (PS) matching was also used to adjust for significant differences in the baseline characteristics between the two groups. RESULTS: Overall, 1921 diabeticpatients were included: 744 intermediate/long-acting HI and 1177 glargine users. During the 3-year follow-up, 209 (28.1%) incident events of any diabetic complication occurred in the intermediate/long-acting HI and 159 (13.5%) in the glargine group. After adjustment for covariates, glargine users had an HR (95% CI) of 0.57 (0.44-0.74) for any diabetic complication and HRs of 0.61 (0.44-0.84), 0.58 (0.33-1.04) and 0.35 (0.18-0.70) for macrovascular, microvascular and metabolic complications, respectively, compared to intermediate/long-acting HI users. PS analyses supported these findings. CONCLUSIONS: The use of glargine is associated with a lower risk of macrovascular complications compared with traditional basal insulins. However, limitations inherent to the study design including the short length of observation and the lack of data on metabolic control or diabetes duration, do not allow us to consider this association as a proof of causality.
Authors: Sara Mucherino; Antonio Gimeno-Miguel; Jonas Carmona-Pirez; Francisca Gonzalez-Rubio; Ignatios Ioakeim-Skoufa; Aida Moreno-Juste; Valentina Orlando; Mercedes Aza-Pascual-Salcedo; Beatriz Poblador-Plou; Enrica Menditto; Alexandra Prados-Torres Journal: Int J Environ Res Public Health Date: 2021-04-21 Impact factor: 3.390
Authors: Simona Cammarota; Lucio Marcello Falconio; Dario Bruzzese; Alberico Luigi Catapano; Manuela Casula; Anna Citarella; Luigi De Luca; Maria Elena Flacco; Lamberto Manzoli; Maria Masulli; Enrica Menditto; Andrea Mezzetti; Salvatore Riegler; Ettore Novellino; Gabriele Riccardi Journal: PLoS One Date: 2013-11-07 Impact factor: 3.240
Authors: A Prados-Torres; B Poblador-Plou; A Gimeno-Miguel; A Calderón-Larrañaga; A Poncel-Falcó; L A Gimeno-Feliú; F González-Rubio; C Laguna-Berna; J Marta-Moreno; M Clerencia-Sierra; M Aza-Pascual-Salcedo; A C Bandrés-Liso; C Coscollar-Santaliestra; V Pico-Soler; J M Abad-Díez Journal: Int J Epidemiol Date: 2018-04-01 Impact factor: 7.196