Association of Hospitalizations With Randomized Glycemia-Lowering Treatment in GRADE

Area of Science:

• Endocrinology
• Diabetes Mellitus Management
• Clinical Trials

Background:

• Hospitalizations are a significant concern in managing type 2 diabetes.
• The Glycemia Reduction Approaches in Diabetes (GRADE) study compared multiple glucose-lowering medications.
• Understanding hospitalization risk factors is crucial for patient care.

Purpose of the Study:

• To compare hospitalization rates and identify risk factors among participants in the GRADE study.
• To assess hospitalizations in patients taking metformin and randomized to insulin glargine, glimepiride, liraglutide, or sitagliptin.

Main Methods:

• Utilized intention-to-treat (N=5,047) and on-assigned-treatment (N=4,830) datasets.
• Employed Kaplan-Meier analysis for time to first hospitalization and time-to-event analyses for subsequent hospitalization risk.
• Assessed baseline differences between hospitalized and non-hospitalized participants.

Main Results:

• Over a third of participants (32.4%) experienced at least one hospitalization.
• No significant differences in the incidence of first hospitalization were found across treatment groups in the ITT analysis.
• Liraglutide showed a reduced hazard rate for first hospitalization versus glimepiride in the AT analysis (HR 0.78).
• Factors increasing subsequent hospitalization risk included poor glycemic control (HbA1c >7.5%), prior hospitalizations, and treatment changes.
• Liraglutide assignment reduced subsequent hospitalization risk by 13% compared to glimepiride.

Conclusions:

• Hospitalizations were frequent in the GRADE study, with similar rates across initial treatment groups.
• A modest but statistically significant reduction in subsequent hospitalization risk was observed with liraglutide compared to glimepiride.
• These findings may inform treatment decisions for similar patient populations.