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Trauma risk in elderly boosted by use of insulin, glinides

14 Oct 2018

Elderly adults using hypoglycaemic glucose-lowering drugs (GLDs), such as insulin and glinides, have an excess risk of hospitalization for serious trauma, a recent study has found.

Researchers enrolled 10,743 elderly adults (aged ≥65 years; 68.0 percent female) who had first been hospitalized for trauma and had been followed for at least 365 days by the index date. An age-, sex- and follow-up length-matched control cohort was also included (n=106,629).

At baseline, cases were more likely to be using GLDs than controls (15.8 percent vs 12.3 percent) and were more frequently taking hypoglycaemic GLDs alone (6.8 percent vs 4.2 percent), especially insulin (3.6 percent vs 1.7 percent) and glinides (1.3 percent vs 0.8 percent).

Participants currently on GLD medication were significantly more likely to be admitted for trauma (hazard ratio [HR], 1.13; 95 percent CI, 1.07–1.21). This relationship was more pronounced in those taking hypoglycaemic GLDs (HR, 1.25; 1.14–1.37).

In contrast, using nonhypoglycaemic GLDs alone (HR, 1.06; 0.96–1.18) or both types of GLD (HR, 1.07; 0.96–1.19) did not lead to a higher risk of trauma hospitalization.

Further analysis stratified according to medication type showed that the hypoglycaemic GLDs insulin (HR, 1.47; 1.31–1.66) and glinides (HR, 1.34; 1.11–1.61) were strongly and significantly correlated with the risk of trauma, while sulfonylureas (HR, 1.08; 0.94–1.23) were not.

Assuming a causal relationship, researchers showed that using insulin would increase the absolute risk of trauma from 2.9 percent to 4.3 percent, while use of glinides would correspond to an increase to 3.9 percent.

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