Diabetes Week: Mortality in Diabetes and DPP-4 Inhibitors Compared to Sulfonylureas
This week, Amol, general internal resident at the University of Toronto, and Reena, General Internist at St. Michael’s Hospital in Toronto, discuss two papers:
Reena shares a large registry-based study that found adult patients with Type 2 Diabetes in Sweden had a 15% higher mortality rate than the general population. Amol and Reena wonder why this number is much lower than those reported by other studies in the last 15 years. Could this be due to higher uptake of evidence based therapeutics? Or could it be attributed to Swedish residents having better social determinants of health?
A large observational study found that when combined with metformin, DPP-4 inhibitors are superior to sulfonylureas in treating patients with Type 2 Diabetes. Although a propensity matched analysis was performed, Amol discusses the potential for bias due to unmeasured confounders. In light of these findings and limitations, would Reena and Amol change their practice?
1. Diabetes and mortality: http://www.nejm.org/doi/full/10.1056/NEJMoa1504347
2. DPP-4 inhibitors and sulfonylureas: http://annals.org/article.aspx?articleid=2456123
Music Credits (Creative Commons)
In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart
Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music
Swingin’ Jazz – Nicolai Heidlas https://m.soundcloud.com/nicolai-heidlas/jazz-blues-background-music
All tracks have been modified for the purposes of this podcast.