Study Explores Sulfonylurea-Hypoglycemia Link in Patients with Renal Impairment
Treatment with sulfonylureas raises the risk of hypoglycemia in patients with diabetes and severe renal impairment, according to the results of a recent study.
For their study, the researchers examined data from 120,803 new users of non-insulin antidiabetic agents with at least 1 prescription, followed over an 8-year period.
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Using Cox proportional hazard models, the researchers calculated associations between sulfonylurea dose, renal impairment, type of sulfonylurea used, and risk of hypoglycemia.
Overall, the risk of hypoglycemia in current users of sulfonylureas only was significantly increased compared with current users of metformin only, but was further increased in participants with estimated glomerular filtration rate of less than 30 mL/min/1.73 m2. Higher sulfonylurea dose and current use of glyburide also increased the risk.
"The findings of this large observational study suggest that the risk of hypoglycaemia is significantly increased in current users of sulfonylureas only with severe renal impairment compared with users of metformin only. Moreover, the results of this study provide evidence that the use of high sulfonylurea doses should be considered with caution in patients with renal impairment," the researchers concluded.
—Michael Potts
Reference:
van Dalem J, Brouwers MCGJ, Stehouwer CDA, et al. Risk of hypoglycaemia in users of sulphonylureas compared with metformin in relation to renal function and sulphonylurea metabolite group: population based cohort study [published online July 13, 2016]. BMJ. doi: http://dx.doi.org/10.1136/bmj.i3625.