Sulfonylureas may be useful for glycemic management in patients with diabetes and liver cirrhosis

Fu-Shun Yen; Jung-Nien Lai; James Cheng-Chung Wei; Lu-Ting Chiu; Chii-Min Hwu; Ming-Chih Hou; Chih-Cheng Hsu

doi:10.1371/journal.pone.0243783

Sulfonylureas may be useful for glycemic management in patients with diabetes and liver cirrhosis

PLoS One. 2020 Dec 14;15(12):e0243783. doi: 10.1371/journal.pone.0243783. eCollection 2020.

Authors

Fu-Shun Yen¹, Jung-Nien Lai^{2

3}, James Cheng-Chung Wei^{4

5

6}, Lu-Ting Chiu^{7

8}, Chii-Min Hwu^{9

10}, Ming-Chih Hou¹¹, Chih-Cheng Hsu^{12

13

14}

Affiliations

¹ Dr. Yen's Clinic, Taoyuan, Taiwan.
² School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
³ Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
⁴ Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung City, Taiwan.
⁵ Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung City, Taiwan.
⁶ Graduate Institute of Integrated Medicine, China Medical University, Taichung City, Taiwan.
⁷ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁸ College of Medicine, China Medical University, Taichung City, Taiwan.
⁹ Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
¹⁰ Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
¹¹ Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
¹² Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
¹³ Department of Health Services Administration, China Medical University, Taichung, Taiwan.
¹⁴ Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.

Abstract

This study aimed to investigate the long-term outcomes of sulfonylurea (SU) use in patients with T2DM and compensated liver cirrhosis. From January 1, 2000, to December 31, 2012, we selected the data of 3781 propensity-score-matched SU users and nonusers from Taiwan's National Health Insurance Research Database. The mean follow-up time for this study was 5.74 years. Cox proportional hazards models with robust sandwich standard error estimates were used to compare the risks of main outcomes between SU users and nonusers. The incidence of mortality during follow-up was 3.24 and 4.09 per 100 person-years for SU users and nonusers, respectively. The adjusted hazard ratios and 95% confidence intervals for all-cause mortality, major cardiovascular events, and decompensated cirrhosis in SU users relative to SU nonusers were 0.79 (0.71-0.88), 0.69 (0.61-0.80), and 0.82 (0.66-1.03), respectively. The SU-associated lower risks of death and cardiovascular events seemed to have a dose-response trend. This population-based cohort study demonstrated that SU use was associated with lower risks of death and major cardiovascular events compared with SU non-use in patients with T2DM and compensated liver cirrhosis. SUs may be useful for glycemic management for patients with liver cirrhosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / etiology
Diabetes Mellitus, Type 2 / complications
Diabetes Mellitus, Type 2 / drug therapy*
Diabetes Mellitus, Type 2 / mortality
Dose-Response Relationship, Drug
Female
Humans
Hypoglycemic Agents / adverse effects
Hypoglycemic Agents / therapeutic use*
Incidence
Liver Cirrhosis / complications*
Liver Cirrhosis / mortality
Longitudinal Studies
Male
Middle Aged
Propensity Score
Proportional Hazards Models
Risk Factors
Sulfonylurea Compounds / adverse effects
Sulfonylurea Compounds / therapeutic use*
Young Adult

Substances

Hypoglycemic Agents
Sulfonylurea Compounds

Grants and funding

This study is supported in part by Taiwan’s Ministry of Health and Welfare Clinical Trial Center (MOHW109-TDU-B-212-114004), Ministry of Science and Technology Clinical Trial Consortium for Stroke (MOST 108-2321-B-039-003), Tseng-Lien Lin Foundation, Taichung, Taiwan (URL of each funder website: https://www.taiwanclinicaltrials.tw/ctc; http://www.ltl-charity.org.tw/about.php?id=4). These funding agencies did not influence the study design, data collection and analysis, decision to publish, or manuscript preparation. The writing and preparation of this paper was not funded by any organization, and employees of funders or any author who received the funding did not undertake data analysis. The funders did not offer support for writing. The corresponding authors had complete access to all data in the study and final responsibility for the publication decision. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.