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Titolo:
INDIVIDUAL SULFONYLUREAS AND SERIOUS HYPOGLYCEMIA IN OLDER-PEOPLE
Autore:
SHORR RI; RAY WA; DAUGHERTY JR; GRIFFIN MR;
Indirizzi:
METHODIST HOSP MEMPHIS,DEPT MED EDUC,1265 UNION AVE MEMPHIS TN 38104 VANDERBILT UNIV,SCH MED,DEPT PREVENT MED,DIV PHARMACOEPIDEMIOL NASHVILLE TN 37212
Titolo Testata:
Journal of the American Geriatrics Society
fascicolo: 7, volume: 44, anno: 1996,
pagine: 751 - 755
SICI:
0002-8614(1996)44:7<751:ISASHI>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEPENDENT DIABETES-MELLITUS; AGENTS; GLIPIZIDE; MANAGEMENT; GLYBURIDE; THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Physical, Chemical & Earth Sciences
Science Citation Index Expanded
Citazioni:
33
Recensione:
Indirizzi per estratti:
Citazione:
R.I. Shorr et al., "INDIVIDUAL SULFONYLUREAS AND SERIOUS HYPOGLYCEMIA IN OLDER-PEOPLE", Journal of the American Geriatrics Society, 44(7), 1996, pp. 751-755

Abstract

OBJECTIVE: To compare the risk of serious hypoglycemia associated with the use of individual sulfonylureas in older people. DESIGN: A retrospective cohort study SETTING: The Tennessee Medicaid Program PATIENTS: A total of 13,963 Medicaid enrollees, aged 65 years or older, who were prescribed one of six sulfonylureas from 1985 to 1989. MAIN OUTCOMEMEASURE: Hospitalization, emergency room admission, or death associated with neuroglycopenic or autonomic symptoms, myocardial infarction, stroke, or injury, with a concomitant blood glucose determination of less than 2.8 mmol/L (50 mg/dL). RESULTS: We identified 255 persons with a first episode of serious hypoglycemia during 20,715 person-years of sulfonylurea use. The crude rate (per 1000 person-years) of serious hypoglycemia was highest in glyburide users, 16.6 (95% confidence interval [CI], 13.2 to 19.9) and lowest among users of tolbutamide, 3.5 (95% CI, 1.2 to 5.9). Users of tolbutamide, tolazamide, and glipizide had lower risks of serious hypoglycemia than users of chlorpropamide, whereas the risk of serious hypoglycemia among glyburide users did not differ from that of chlorpropamide users. Among second generation sulfonylureas, the adjusted relative risk of severe hypoglycemia among glyburide users, compared with glipizide users, was 1.9 (95% CI, 1.2 to 2.9). An increased risk of serious hypoglycemia associated with use of glyburide compared with glipizide occurred in all strata, including those defined by gender, race, nursing home residence, dose, and durationof use. CONCLUSIONS: Significant differences in risk of serious hypoglycemia were observed among users of individual agents. This may be explained by duration, timing, or potency of hypoglycemic action. These data confirm previous findings that chlorpropamide use is associated with high risk of hypoglycemia and indicate that among second generation sulfonylureas, glipizide is less associated with hypoglycemia than is glyburide. More information comparing the effectiveness of glycemic control among individual sulfonylureas is needed to assist prescribersin selecting a specific agent for use in clinical practice.

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Documento generato il 29/03/20 alle ore 17:14:04