Kyoung Hwa Ha , Minae Park , Yujin Lee , Dae Jung Kim , Seung Jin Han
{"title":"SGLT2抑制剂治疗继发于外分泌胰腺疾病的糖尿病患者的心肾结局和安全性:一项基于全国人群的研究","authors":"Kyoung Hwa Ha , Minae Park , Yujin Lee , Dae Jung Kim , Seung Jin Han","doi":"10.1016/j.diabet.2025.101668","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>Limited data are available on the effectiveness of pharmacological treatments for diabetes secondary to disorders of the exocrine pancreas (DEP). This study evaluated the real-world effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in individuals with DEP.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Korean National Health Insurance Service database. Data on 66,120 individuals with DEP who initiated glucose-lowering drugs (GLDs) between September 2014 and December 2022 were analyzed. Patients initiating SGLT2 inhibitors were matched 1:1 with patients initiating other GLDs using propensity-score matching. The effectiveness outcomes included major adverse cardiovascular events (MACEs), heart failure, end-stage kidney disease (ESKD), and all-cause mortality. The safety outcomes included hypoglycemia, diabetic ketoacidosis, genital infections, urinary tract infections, fractures, pancreatitis, and pancreatic cancer.</div></div><div><h3>Results</h3><div>After matching, 4,128 SGLT2 inhibitor-other GLD user pairs were included in the analysis, with a mean follow-up of 2.3 years. Compared with use of other GLDs, use of SGLT2 inhibitors was associated with a significantly lower risk of MACE (hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.51–0.93), hospitalization for heart failure (HR: 0.70; 95% CI: 0.51–0.95), ESKD (HR: 0.19; 95% CI: 0.06–0.61), and all-cause mortality (HR: 0.38; 95% CI: 0.27–0.53). SGLT2 inhibitor use was associated with a reduced risk of urinary tract infections (HR: 0.87; 95% CI: 0.78–0.96) and pancreatitis (HR 0.71; 95% CI 0.58–0.87).</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors were associated with a reduced risk of adverse cardiorenal outcomes and all-cause mortality and were safely used in patients with DEP.</div></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":"51 5","pages":"Article 101668"},"PeriodicalIF":4.7000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cardiorenal outcomes and safety of SGLT2 inhibitors in patients with diabetes secondary to disorders of the exocrine pancreas: a nationwide population-based study\",\"authors\":\"Kyoung Hwa Ha , Minae Park , Yujin Lee , Dae Jung Kim , Seung Jin Han\",\"doi\":\"10.1016/j.diabet.2025.101668\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><div>Limited data are available on the effectiveness of pharmacological treatments for diabetes secondary to disorders of the exocrine pancreas (DEP). This study evaluated the real-world effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in individuals with DEP.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Korean National Health Insurance Service database. Data on 66,120 individuals with DEP who initiated glucose-lowering drugs (GLDs) between September 2014 and December 2022 were analyzed. Patients initiating SGLT2 inhibitors were matched 1:1 with patients initiating other GLDs using propensity-score matching. The effectiveness outcomes included major adverse cardiovascular events (MACEs), heart failure, end-stage kidney disease (ESKD), and all-cause mortality. The safety outcomes included hypoglycemia, diabetic ketoacidosis, genital infections, urinary tract infections, fractures, pancreatitis, and pancreatic cancer.</div></div><div><h3>Results</h3><div>After matching, 4,128 SGLT2 inhibitor-other GLD user pairs were included in the analysis, with a mean follow-up of 2.3 years. Compared with use of other GLDs, use of SGLT2 inhibitors was associated with a significantly lower risk of MACE (hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.51–0.93), hospitalization for heart failure (HR: 0.70; 95% CI: 0.51–0.95), ESKD (HR: 0.19; 95% CI: 0.06–0.61), and all-cause mortality (HR: 0.38; 95% CI: 0.27–0.53). SGLT2 inhibitor use was associated with a reduced risk of urinary tract infections (HR: 0.87; 95% CI: 0.78–0.96) and pancreatitis (HR 0.71; 95% CI 0.58–0.87).</div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitors were associated with a reduced risk of adverse cardiorenal outcomes and all-cause mortality and were safely used in patients with DEP.</div></div>\",\"PeriodicalId\":11334,\"journal\":{\"name\":\"Diabetes & metabolism\",\"volume\":\"51 5\",\"pages\":\"Article 101668\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-05-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes & metabolism\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S126236362500062X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes & metabolism","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S126236362500062X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Cardiorenal outcomes and safety of SGLT2 inhibitors in patients with diabetes secondary to disorders of the exocrine pancreas: a nationwide population-based study
Aims
Limited data are available on the effectiveness of pharmacological treatments for diabetes secondary to disorders of the exocrine pancreas (DEP). This study evaluated the real-world effectiveness and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in individuals with DEP.
Methods
A retrospective cohort study was conducted using data from the Korean National Health Insurance Service database. Data on 66,120 individuals with DEP who initiated glucose-lowering drugs (GLDs) between September 2014 and December 2022 were analyzed. Patients initiating SGLT2 inhibitors were matched 1:1 with patients initiating other GLDs using propensity-score matching. The effectiveness outcomes included major adverse cardiovascular events (MACEs), heart failure, end-stage kidney disease (ESKD), and all-cause mortality. The safety outcomes included hypoglycemia, diabetic ketoacidosis, genital infections, urinary tract infections, fractures, pancreatitis, and pancreatic cancer.
Results
After matching, 4,128 SGLT2 inhibitor-other GLD user pairs were included in the analysis, with a mean follow-up of 2.3 years. Compared with use of other GLDs, use of SGLT2 inhibitors was associated with a significantly lower risk of MACE (hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.51–0.93), hospitalization for heart failure (HR: 0.70; 95% CI: 0.51–0.95), ESKD (HR: 0.19; 95% CI: 0.06–0.61), and all-cause mortality (HR: 0.38; 95% CI: 0.27–0.53). SGLT2 inhibitor use was associated with a reduced risk of urinary tract infections (HR: 0.87; 95% CI: 0.78–0.96) and pancreatitis (HR 0.71; 95% CI 0.58–0.87).
Conclusions
SGLT2 inhibitors were associated with a reduced risk of adverse cardiorenal outcomes and all-cause mortality and were safely used in patients with DEP.
期刊介绍:
A high quality scientific journal with an international readership
Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing.
Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.