Authors
John-Michael Gamble, Eugene Chibrikov, Laurie K Twells, William K Midodzi, Stephanie W Young, Don MacDonald, Sumit R Majumdar
Publication date
2017/1/1
Journal
The lancet Diabetes & endocrinology
Volume
5
Issue
1
Pages
43-52
Publisher
Elsevier
Description
Background
Existing studies have shown conflicting evidence regarding the safety of exogenous insulin therapy in patients with type 2 diabetes. In particular, observational studies have reported an increased risk of death and cardiovascular disease among users of higher versus lower doses of insulin. We aimed to quantify the association between increasing dosage of insulin exposure and death and cardiovascular events, while taking into account time-dependent confounding and mediation that might have biased previous studies.
Methods
We did a cohort study using primary care records from the UK-based Clinical Practice Research Datalink (CPRD). New users of metformin monotherapy were identified in the period between Jan 1, 2001, and Dec 31, 2012. We then identified those in this group with a new prescription for insulin. Insulin exposure was categorised into groups according to the mean dose (units …
Total citations
201720182019202020212022202320247145610763
Scholar articles