| Title |
Real-world antidiabetic drug use and fracture risk in 12,277 patients with type 2 diabetes mellitus: a nested case–control study
|
|---|---|
| Published in |
Osteoporosis International, June 2018
|
| DOI | 10.1007/s00198-018-4581-y |
| Pubmed ID | |
| Authors |
E. Losada, B. Soldevila, M.S. Ali, D. Martínez-Laguna, X. Nogués, M. Puig-Domingo, A. Díez-Pérez, D. Mauricio, D. Prieto-Alhambra |
| Abstract |
We conducted a nested case-control study to study the association between antidiabetic treatments (alone or in combination) use and fracture risk among incident type 2 Diabetes mellitus patients. We found an increased risk of bone fracture with insulin therapy compared to metformin monotherapy. Patients with type 2 diabetes mellitus (T2DM) have an increased risk of fragility fractures, to which antidiabetic therapies may contribute. We aimed to characterize the risk of fracture associated with different antidiabetic treatments as usually prescribed to T2DM patients in actual practice conditions. A case-control study was nested within a cohort of incident T2DM patients registered in 2006-2012 in the Information System for Research Development in Primary Care (Catalan acronym, SIDIAP), a database which includes records for > 5.5 million patients in Catalonia (Spain). Each case (incident major osteoporotic fracture) was risk-set matched with up to five same-sex controls by calendar year of T2DM diagnosis and year of birth (± 10 years). Study exposure included previous use of all antidiabetic medications (alone or in combination), as dispensed in the 6 months before the index date, with metformin (MTF) monotherapy, the most commonly used drug, as a reference group (active comparator). Data on 12,277 T2DM patients (2049 cases and 10,228 controls) were analyzed. Insulin use was associated with increased fracture risk (adjusted OR 1.63 (95% CI 1.30-2.04)), as was the combination of MTF and sulfonylurea (SU) (adjusted OR 1.29 (1.07-1.56)), compared with MTF monotherapy. Sensitivity analyses suggest possible causality for insulin therapy but not for the MTF + SU combination association. No significant association was found with any other antidiabetic medications. Insulin monotherapy was associated with an increased fracture risk compared to MTF monotherapy in T2DM patients. Fracture risk should be taken into account when starting a glucose-lowering drug as part of T2DM treatment. |
X Demographics
The data shown below were collected from the profiles of 25 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 5 | 20% |
| United States | 2 | 8% |
| India | 1 | 4% |
| Switzerland | 1 | 4% |
| Argentina | 1 | 4% |
| Australia | 1 | 4% |
| France | 1 | 4% |
| Netherlands | 1 | 4% |
| United Kingdom | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 11 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 17 | 68% |
| Scientists | 6 | 24% |
| Practitioners (doctors, other healthcare professionals) | 2 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 74 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 74 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 11% |
| Student > Ph. D. Student | 7 | 9% |
| Researcher | 6 | 8% |
| Student > Bachelor | 5 | 7% |
| Other | 5 | 7% |
| Other | 15 | 20% |
| Unknown | 28 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 28 | 38% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 8% |
| Nursing and Health Professions | 5 | 7% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Chemistry | 1 | 1% |
| Other | 2 | 3% |
| Unknown | 30 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 34. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 September 2018.
All research outputs
#1,063,331
of 23,577,654 outputs
Outputs from Osteoporosis International
#135
of 3,710 outputs
Outputs of similar age
#24,867
of 331,009 outputs
Outputs of similar age from Osteoporosis International
#10
of 58 outputs
Altmetric has tracked 23,577,654 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,710 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,009 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 58 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.