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Decreased Mortality After Long-Term Treatment With Dipeptidyl Peptidase-4 Inhibitors: A Retrospective Study of U.S. Veterans With Type 2 Diabetes.
- Source :
-
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2022 Jan; Vol. 28 (1), pp. 8-15. Date of Electronic Publication: 2021 Aug 08. - Publication Year :
- 2022
-
Abstract
- Objective: The prevalence of chronic kidney disease (CKD) in the United States is 13% of the general population. Among those with CKD, diabetic nephropathy is the leading cause of end-stage renal disease. This is a retrospective study examining the effect of long-term use of dipeptidyl peptidase-4 (DPP-4) inhibitors on all-cause mortality and progression of renal disease in the veteran population.<br />Methods: Data was extracted using the Veterans Administration Informatics and Computing Infrastructure. A large cohort of veterans diagnosed with type 2 diabetes mellitus were used to identify patients on DPP-4 inhibitors and without DPP-4 inhibitors. Groups were compared to determine the effect of DPP-4 inhibitors on the progression of CKD and all-cause mortality. Data were analyzed using SAS.<br />Results: Subjects in the treatment group (n = 40 558) had baseline variables (age, body mass index, race) similar to the control group (n = 40 558). Diabetes control improved in the treatment group (HgbA1c, 8.3% [67 mmol/mol] to 7.8% [62 mmol/mol]; P < .001) but not in the control group (HgbA1c, 7.4% [57 mmol/mol] to 7.3% [56 mmol/mol]). New diagnoses of heart failure and coronary artery bypass grafts were clinically significant (odds ratios = 0.66 and 0.52). No change in progression of CKD was seen in either group. All-cause mortality was reduced by 59%.<br />Conclusion: We conclude that DPP-4 inhibitors are associated with a significant reduction in all-cause mortality independent of glucose control, albeit with no clear cause, including obtainable cardiovascular outcomes. Our data is consistent with prior trials in that DPP-4 inhibitors did not show a significant change in serum creatinine or microalbuminuria.<br /> (Copyright © 2021 AACE. All rights reserved.)
- Subjects :
- Aged
Female
Humans
Male
Middle Aged
Renal Insufficiency, Chronic etiology
Renal Insufficiency, Chronic mortality
Retrospective Studies
United States epidemiology
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 drug therapy
Diabetes Mellitus, Type 2 mortality
Dipeptidyl-Peptidase IV Inhibitors therapeutic use
Hypoglycemic Agents therapeutic use
Renal Insufficiency, Chronic drug therapy
Veterans
Subjects
Details
- Language :
- English
- ISSN :
- 1530-891X
- Volume :
- 28
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
- Publication Type :
- Academic Journal
- Accession number :
- 34371197
- Full Text :
- https://doi.org/10.1016/j.eprac.2021.07.017