Evaluation of weight change and hypoglycaemia as mediators in the association between insulin use and death.

ABSTRACT:

Aim

To evaluate whether weight change or hypoglycaemia mediates the association between insulin use and death.

Materials and methods

In a retrospective cohort of veterans who filled a new prescription for metformin and added insulin or sulphonylurea (2001-2012), we assessed change in body mass index (BMI) and hypoglycaemia during the first 12 months of treatment intensification. Cox proportional hazards models compared the risk of death between treatment groups. Using the difference method, we estimated the indirect effect and proportion mediated through each mediator. A sensitivity analysis assessed mediators in the first 6 months of intensified therapy.

Results

Among 28 892 patients surviving 12 months, deaths per 1000 person-years were 15.4 for insulin users and 12

SUBMITTER: Min JY 

PROVIDER: S-EPMC7055153 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature