The association between duration of metformin and sulfonylurea treatment and microvascular complications in patients with incident type 2 diabetes: a pooled cohort analysis.

IF 1.6 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-04-01 eCollection Date: 2025-06-01 DOI:10.1007/s40200-025-01577-w

Mansour Bahardoust, Yadollah Mehrabi, Farzad Hadaegh, Fereidoun Azizi, Davood Khalili, Ali Delpisheh

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引用次数: 0

Abstract

Objectives: The effect of the duration of medication with metformin and sulfonylurea (SUs) on microvascular complications based on the duration of type 2 diabetes (DM2) is unclear. The aim of this study was to investigate the association of medication time with metformin and SUs and microvascular complications in newly diagnosed DM2 patients.

Methods: In this prospective multi-cohort study, data from 3,904 newly diagnosed DM from three cohorts of the Tehran Lipid and Glucose Study (TLGS), the Multi-Ethnic Study of Atherosclerosis (MESA), and the Atherosclerosis Risk in Communities (ARIC) with a mean age of 59.6 ± 08 years were pooled. Metformin medication time alone, SUs alone, and a combination of both since drug initiation were defined as exposure. The incidence of microvascular complications (diabetic nephropathy or retinopathy) was defined as outcomes. The cumulative exposure to metformin, SUs, aspirin, statin, and anti-hypertensive medication was also determined using the same approach.

Results: Metformin alone, SUs alone, and the combination of both reduced the hazard of microvascular complications by 8%(HR_Adj: 0.92, 95% CI: 0.89, 0.96, P: 0.001), 6%(HR_Adj: 0.94, 95% CI: 0.92, 0.97, P: 0.004), and 9%(HR_Adj: 0.91, 95% CI: 0.89, 0.94, P: 0.001) for each year of use, respectively (p < 0.05). The protective effect of metformin and SUs, individually or in combination, on microvascular complications started approximately five years after the initial treatment and continued until approximately 15 years after the initial treatment and then reached a plato.

Conclusion: long-term use of metformin and SUs individually and in combination was associated with a decrease in the risk of microvascular outcomes in newly diagnosed DM for up to about one decade. These findings highlight the importance of choosing an appropriate treatment regimen for new patients with type 2 diabetes. Appropriate oral therapy can minimize microvascular complications and improve overall well-being.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01577-w.

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二甲双胍和磺脲类药物治疗持续时间与 2 型糖尿病患者微血管并发症之间的关系：队列汇总分析。

目的：二甲双胍和磺脲（SUs）联合用药时间对2型糖尿病（DM2）患者微血管并发症的影响尚不清楚。本研究旨在探讨新诊断DM2患者用药时间与二甲双胍、SUs及微血管并发症的关系。方法：在这项前瞻性多队列研究中，收集了来自德黑兰脂糖研究（TLGS）、多民族动脉粥样硬化研究（MESA）和社区动脉粥样硬化风险（ARIC）三个队列的3904名新诊断的糖尿病患者的数据，平均年龄为59.6±08岁。单用二甲双胍的时间，单用SUs的时间，以及自用药以来两者的组合被定义为暴露。微血管并发症（糖尿病肾病或视网膜病变）的发生率被定义为结局。二甲双胍、SUs、阿司匹林、他汀类药物和抗高血压药物的累积暴露量也采用相同的方法测定。结果:二甲双胍,SUs,两者的结合微血管并发症的风险降低了8% (HRAdj: 0.92, 95% CI: 0.89, 0.96, P: 0.001), 6% (HRAdj: 0.94, 95% CI: 0.92, 0.97, P: 0.004),和9% (HRAdj: 0.91, 95% CI: 0.89, 0.94, P: 0.001)每年的使用,分别(P结论:长期使用二甲双胍和SUs单独和组合与微血管的结果的风险减少新诊断DM大约一个十年。这些发现强调了为新发2型糖尿病患者选择合适治疗方案的重要性。适当的口腔治疗可以减少微血管并发症，改善整体健康。补充资料：在线版本提供补充资料，网址为10.1007/s40200-025-01577-w。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.