| Title: |
Metformin Treatment is Associated with Reduced Risk of Hypoglycaemia, Major Adverse Cardiovascular Events, and All-Cause Mortality in Patients with Post-pancreatitis Diabetes Mellitus: A Nationwide Cohort Study |
| Authors: |
Davidsen, Line; Jensen, Morten H.; Cook, Mathias E.; Vestergaard, Peter; Knop, Filip K.; Drewes, Asbjørn M.; Olesen, Søren S. |
| Source: |
Davidsen, L, Jensen, M H, Cook, M E, Vestergaard, P, Knop, F K, Drewes, A M & Olesen, S S 2024, 'Metformin Treatment is Associated with Reduced Risk of Hypoglycaemia, Major Adverse Cardiovascular Events, and All-Cause Mortality in Patients with Post-pancreatitis Diabetes Mellitus: A Nationwide Cohort Study', European Journal of Endocrinology, vol. 190, no. 1, pp. 44-53. https://doi.org/10.1093/ejendo/lvad175 |
| Publication Year: |
2024 |
| Collection: |
Aalborg University (AAU): Publications / Aalborg Universitet: Publikationer |
| Subject Terms: |
Adult; Cardiovascular Diseases/drug therapy; Cohort Studies; Diabetes Mellitus; Type 2/complications; Glucose; Humans; Hypoglycemia/chemically induced; Hypoglycemic Agents/adverse effects; Metformin/adverse effects; Pancreatitis/drug therapy |
| Description: |
OBJECTIVE: Post-pancreatitis diabetes mellitus (PPDM) is a frequent complication of pancreatitis and is associated with an increased risk of adverse outcomes. Metformin is recommended for the treatment of PPDM, but evidence of its risk-benefit profile is limited. In a pharmaco-epidemiologic study, we investigated the association between metformin treatment and adverse outcomes in patients with PPDM. DESIGN AND METHODS: In a Danish nationwide population-based cohort study, we included adults (≥18 years) with incident PPDM or type 2 diabetes between 2009 and 2018. Post-pancreatitis diabetes mellitus was categorised into acute and chronic subtypes (PPDM-A and PPDM-C). Associations between metformin treatment and severe hypoglycaemia, major adverse cardiovascular events (MACE), and all-cause mortality were examined across the diabetes subgroups using Cox regression analysis. Treatments with metformin, insulin, and other glucose-lowering therapies were handled as time-varying exposures. RESULTS: We included 222 337 individuals with new-onset type 2 diabetes and 3781 with PPDM, of whom 2305 (61%) were classified as PPDM-A and 1476 (39%) as PPDM-C. Treatment with metformin was associated with a lower risk of severe hypoglycaemia (adjusted hazard ratio [HR] 0.41, 95% CI 0.27-0.62, P < .0001), MACE (HR 0.74, 95% CI 0.60-0.92, P = .0071), and all-cause mortality (HR 0.56, 95% CI 0.49-0.64, P < .0001) in patients with PPDM. In sensitivity analyses and among individuals with type 2 diabetes, metformin treatment exhibited comparable trends of risk reduction. CONCLUSIONS: Metformin is associated with a lower risk of adverse outcomes, including all-cause mortality in patients with PPDM, supporting the use of metformin as a glucose-lowering therapy for these patients. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| ISSN: |
0804-4643; 1479-683X |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38134412; info:eu-repo/semantics/altIdentifier/pissn/0804-4643; info:eu-repo/semantics/altIdentifier/eissn/1479-683X |
| DOI: |
10.1093/ejendo/lvad175 |
| Availability: |
https://vbn.aau.dk/da/publications/12ce4622-1032-49d2-ac04-3868b241e30c; https://doi.org/10.1093/ejendo/lvad175; https://vbn.aau.dk/ws/files/626080435/lvad175.pdf; https://www.scopus.com/pages/publications/85181766284 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.2AF5F07 |
| Database: |
BASE |