10 research outputs found
The Use of Alendronate Is Associated with a Decreased Incidence of Type 2 Diabetes Mellitus—A Population-Based Cohort Study in Taiwan
<div><p>Purpose</p><p>Bone remodeling has been linked to glucose metabolism in animal studies, but the results of human trials were inconclusive. Bisphosphonates may play a role in glucose metabolism through their impacts on bone remodeling enzymes. In this study, we aimed to examine the influence of alendronate usage on the incidence of type 2 diabetes mellitus (DM) among osteoporotic patients.</p><p>Methods</p><p>A retrospective cohort study was designed to include osteoporotic patients without DM from a population-based cohort containing 1,000,000 subjects. Patients treated with alendronate (exposed group, N=1,011) were compared with those who received no treatment (age and gender matched non-exposed group, N=3,033). Newly diagnosed DM was identified from medical records by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM) code. The incidence of DM in both groups was calculated for comparison.</p><p>Results</p><p>The non-exposed group had a significantly higher incidence of DM (Odds ratio 1.21, 95% confidence interval 1.03~1.41) when compared with the exposed group. In subgroup analysis, the DM risk reduction in exposed group was only significant among those younger than 65 years and those without hypertension or dyslipidemia. Patients who were prescribed alendronate more than or equal to 3 times had demonstrated a significant reduction in DM risk.</p><p>Conclusions</p><p>Our study showed alendronate might yield a protective effect for incident DM. This effect became insignificant in patients with older age, dyslipidemia or hypertension. The underlying mechanism needs further exploration with prospective data for confirmation of the observed findings.</p></div
Comparison for Incidence of type 2 DM between exposed and non-exposed group.
<p>*IRR: Incidence related risk</p><p>**IR: Incidence Rate, per 10,000 persons per year</p><p>Comparison for Incidence of type 2 DM between exposed and non-exposed group.</p
Multivariate logistic regression for having at least one drug as potentially inappropriate.
<p>*<i>P</i><0.05,</p><p>**<i>P</i><0.01,</p><p>***<i>P</i><0.001.</p
Clinic visit-level bivariate analysis (N = 605239) according to the three sets of potentially inappropriate medication criteria.
<p>Abbreviations: MD- Medical Doctor, NTD- New Taiwan dollar.</p><p>***<i>P</i><0.001.</p
Characteristics of the three sets of explicit criteria and their performance in detecting potentially inappropriate medications.
<p>*Statements are those for potentially inappropriate medications without considering drug-disease or drug-syndrome interactions.</p
Multivariate logistic regression for having at least one potentially inappropriate medication in one clinic visit.
<p>***<i>P</i><0.0001.</p
Basic characteristics of the home healthcare recipients.
<p>Basic characteristics of the home healthcare recipients.</p
Patient-level bivariate analysis (N = 25187) by the presence of least one PIM according to the three sets of potentially inappropriate medication criteria.
<p>***<i>P</i><0.0001.</p
The leading ten potentially inappropriate medications (PIMs) identified in 2,428,222 prescribed medications.
<p>Beers criteria- 2012 version of Beers criteria, PIM-Taiwan criteria- potentially inappropriate medication Taiwan criteria.</p><p>*Zolpidem is considered as PIMs if daily dose is more than 5 mg in PRISCUS criteria but as PIMs regardless of daily dose in 2012 version of Beers criteria.</p