Mortality in Individuals Treated With Glucose-Lowering Agents: A Large, Controlled Cohort Study.

Context: Several observational studies and meta-analyses have reported increased mortality of patients taking sulfonylurea and insulin. The impact of patient profiles and concomitant therapies often remains unclear. Objective: The objective of the study was to quantify survival of patients after starting glucose-lowering agents (GLAs) and compare it with control subjects, matched for risk profiles and concomitant therapies. Design: This was a retrospective, controlled, cohort study. Setting: The study is based on health expenditure records of the largest Belgian health mutual insurer, covering more than 4.4 million people. Patients: A total of 115 896 patients starting metformin, sulfonylurea, or insulin (alone or in combination) between January 2003 and December 2007 participated in the study. Control subjects without GLA therapy were matched for age, gender, history of cardiovascular events, and therapy with antihypertensives, statins and blood platelet aggregation inhibitors. Intervention(s): There wer...