Research on Hypoglycemia Risk in Combination Therapy with Dipeptidyl Peptidase-4 Inhibitors and Other Oral Antidiabetes Medications in Patients with Diabetes Mellitus

• Main Authors: Yu-Chieh Cheng, 鄭宇傑
• Other Authors: 黃光華
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/5rh588

碩士 === 中國醫藥大學 === 醫務管理學系碩士班 === 102 === Background and Object: Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of drug that can be used for treating diabetes. However, whether administering DPP-4 inhibitors causes the side effect of hypoglycemia has not been determined. The objective of this study was to understand the factors that influence patients with diabetes who use DPP-4 inhibitors or who use DPP-4 inhibitors combined with other oral antidiabetes drugs. The correlation between the influential factors and the risk of hypoglycemia was also discussed. Method: The data sources were the Longitudinal Cohort of Diabetes Patients from the National Health Insurance Research Database published by the National Health Research Institutes(LHID2010). The research participants were patients who were aged 20 years or above, experienced hospitalization because of a diabetes diagnosis or three or more diabetes diagnoses within 365 days after first outpatient visit, and were prescribed with 2 types of antidiabetes drug. The patients were grouped based on whether they used DPP-4 inhibitors. A binary logistic regression model was used to analyze the correlation factors of whether the patients with diabetes used DPP-4 inhibitors and a generalized logistic regression model was used to analyze the correlation factors of patients with diabetes using DPP-4 inhibitors combined with other oral antidiabetes drugs. The proportional hazards regression model was used to analyze the correlation between the risks of hypoglycemia and the 2 medication methods. Result:The patients who suffered from diabetes for an extended period, sought treatment in comparatively higher-level private hospitals, and had a relatively younger attending physician were more likely to use DPP-4 inhibitors. The patients using DPP-4 inhibitors combined with the non-sulfonylurea insulin secretagogue were adopted as the control group. Patients who visited public hospitals tended to receive medications combining DPP-4 inhibitors and sulfonylurea. The odds ratio of whether the patients used DPP-4 inhibitors or DPP-4 inhibitors combined with other oral antidiabetes drugs to the risk of hypoglycemia did not exhibit a statistically significant difference. Conclusion:No statistical significant connection existed between the use of DPP-4 inhibitors or DPP-4 inhibitors combined with other oral antidiabetes drugs and the risk of hypoglycemia. Thus, the results showed that using DPP-4 inhibitors is probably a safe treatment method for patients with diabetes.