title: Cardiovascular events and insulin therapy: a retrospective cohort analysis.
abstract: To investigate the impact of insulin plus other risk factors on cardiovascular disease (CVD) events in patients with type 2 diabetes (T2D), we conducted a retrospective study among patients with T2D from a U.S. managed care plan (n=342,692). Date of first CVD event was defined as index date. For patients without events, index date was date of last-observed claim. CVD event rates were calculated; odds of CVD event were compared for patients with/without insulin use. Events analyzed included stroke, MI, other cardiac/cerebrovascular events. Among insulin group (n=14,167), 22 patients/1000 patient-years experienced a CVD event, compared with 19/1000 patient-years in non-insulin group (n=328,077). Adjusting for risk factors and comorbidities, odds of event for insulin group compared to non-insulin group was 0.66, ranging from 25% lower for patients aged 65+ to 42% lower for patients aged 31-45. Insulin treatment of T2D was associated with reduced risk of CVD events compared to other or no therapy.
authors.affiliation: i3 Innovus, An Ingenix Company, MN 002-0258, 12125 Technology Drive, Eden Prairie, MN 55344, USA. nicole.engel-nitz@i3innovus.com
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Engel-Nitz
authors.forename: Sherry
authors.initials: S
authors.lastname: Martin
authors.forename: Peter
authors.initials: P
authors.lastname: Sun
authors.forename: Don
authors.initials: D
authors.lastname: Buesching
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin