诺基诺和严重低血糖的风险在硫基尿素的使用者:基于人口的队列研究
Jenny Dimakos1, Ying Cui2, Robert W Platt2,3,4
1Department of Medicine, McGill University, Montreal, Canada.
Diabetes, obesity & metabolism
|May 3, 2024
概括
诺基诺并没有增加在服用硫类尿素的患者中严重低血糖的风险. 然而,年轻的成年人 (65岁以下) 可能面临更高的风险,需要进一步调查.
科学领域:
- 药物监督 药物监督 药物监督
- 临床药理学 临床药理学
- 流行病学 流行病学
背景情况:
- 诺可以引起罕见但严重的低血糖症.
- 糖尿病患者使用硫类尿素有高降血糖的风险.
- 在这个人群中,诺基诺和阿莫西西林之间严重低血糖的比较风险尚未得到充分确立.
研究的目的:
- 为了评估与阿莫西西林相比,诺基诺使用和严重低血糖之间的关联,在同时接受硫类尿素治疗的患者中.
- 为了研究年龄,性别和血糖控制的潜在效果修改.
主要方法:
- 基于人口的队列研究,使用英国临床实践研究数据链接Aurum.
- 包括在1998年至2020年期间开始第二代硫氨酸尿素治疗的患者.
- 治疗意图分析比较诺基诺和阿莫西西林使用者之间30天严重低血糖 (住院或死亡) 的风险,使用Cox模型与倾向分数匹配.
主要成果:
- 这项研究包括143,417名患者 (13,123名诺基诺发起者,130,294名阿莫西西林发起者).
- 与阿莫西西林相比,诺基诺与严重低血糖的风险增加无关 (HR 1.17; 95% CI 0.91-1.50).
- 在年轻的成年人 (<65岁) (HR 2.90;95% CI 1.41-5.97) 中观察到风险增加,但在老年人 (≥65岁) 中没有.
结论:
- 与阿莫西西林相比,在使用第二代硫类尿素的患者中,诺基诺与严重低血糖的风险增加无关.
- 在年轻的成年患者中,诺基诺可能存在严重低血糖的潜在风险增加.
- 需要进一步的研究来确认年轻人群的风险增加.
相关概念视频
Oral Hypoglycemic Agents: Sulfonylureas
207
Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
207
Oral Hypoglycemic Agents: Biguanides and Glitazones
192
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
192
Oral Hypoglycemic Agents: Glinides
154
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
154
Antihypertensive Drugs: Thiazide-Class Diuretics
615
Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
615
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
174
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
174
Hypoglycemia and Glucagon
257
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
257


