Relationships between diabetes medication and the risk of acute myocardial infarction, stroke, and coronary artery heart disease in patients with type 2 diabetes -participants in Taiwan national diabetes care management program

Objective There has been a lot of research in diabetes medication and cardiovascular events for western populations, but there is limited data about this relationship for Chinese. The aim of the study was to compare the risk of a composite measure of acute myocardial infarction, stroke, and coronary artery heart disease in patients with type 2 diabetes treated with various types of type 2 diabetes medications in participants of Taiwan National Diabetes Care Management Program.

Methods This study planned a retrospective cohort study consisting of 57,545 Chinese patients with type 2 diabetes who were enrolled in the Taiwan National Diabetes Care Management Program. The baseline period was at 2001−2003 and all identified patients were followed up until December 2010. Extensive adjustments for demographic and clinical variables were made by using Cox proportional hazards regression.

Results A total of 26,840 end points were observed during a median follow−up of 7.3 years. The adjusted hazard ratios of the composite of acute myocardial infarction, stroke, or coronary artery heart disease for patients having three oral medications, insulin only, insulin plus one oral medication, and insulin plus more than one oral medications compared with patients who did not have medication were 1.10 (95% confidence interval: 1.03,1.17), 1.31 (1.19,1.44), 1.27 (1.13,1.42), and 1.35 (1.23,1.49), respectively.

Conclusions Our findings indicated that patients with three oral medications, insulin used, either combined with oral medication or not, had an increased risk of acute myocardial infarction, stroke, or coronary artery heart disease.