Comparative Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors vs Sulfonylureas in Patients With Type 2 Diabetes

Bowe, Benjamin; Gibson, Andrew K.; McGill, Janet B.; Maddukuri, Geetha; Al‐Aly, Ziyad

doi:10.1001/jamainternmed.2021.2488

Cited by 39 publications

(41 citation statements)

References 63 publications

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“…The VA Corporate Data Warehouse (CDW) provided demographic and clinical data. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Diagnoses were obtained from VA CDW inpatient and outpatient encounters domains. Laboratory measurements were collected from the CDW laboratory results domain and medication data were collected from the CDW outpatient pharmacy domain and the CDW bar code medication administration domain.…”

Section: Methodsmentioning

confidence: 99%

“…Laboratory measurements were collected from the CDW laboratory results domain and medication data were collected from the CDW outpatient pharmacy domain and the CDW bar code medication administration domain. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Information on COVID-19 was obtained from the VA COVID-19 shared data resource. 20 The Area Deprivation Index was used as a summary measure of contextual disadvantage at participants' residential locations.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Risks and burdens of incident diabetes in long COVID: a cohort study

Xie

Al‐Aly

2022

The Lancet Diabetes & Endocrinology

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418

363

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risks and burdens of incident diabetes in long COVID: a cohort study

Xie

Al‐Aly

2022

The Lancet Diabetes & Endocrinology

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418

363

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“…Data used in this study were obtained from the Veteran Affairs Corporate Data Warehouse. 3 4 5 6 7 Within this data warehouse, the patient data domain provided demographic information; the outpatient encounters domain and inpatient encounters domain provided clinical information, including diagnoses and procedures; the outpatient pharmacy and bar code medication administration domains provided pharmacy records; and the laboratory results domain provided laboratory test information. Information on covid-19 was obtained from the Veteran Affairs covid-19 shared data resource.…”

Section: Methodsmentioning

confidence: 99%

Risks of mental health outcomes in people with covid-19: cohort study

Xie

Al‐Aly

2022

BMJ

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292

238

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Objective To estimate the risks of incident mental health disorders in survivors of the acute phase of covid-19. Design Cohort study. Setting US Department of Veterans Affairs. Participants Cohort comprising 153 848 people who survived the first 30 days of SARS-CoV-2 infection, and two control groups: a contemporary group (n=5 637 840) with no evidence of SARS-CoV-2, and a historical control group (n=5 859 251) that predated the covid-19 pandemic. Main outcomes measures Risks of prespecified incident mental health outcomes, calculated as hazard ratio and absolute risk difference per 1000 people at one year, with corresponding 95% confidence intervals. Predefined covariates and algorithmically selected high dimensional covariates were used to balance the covid-19 and control groups through inverse weighting. Results The covid-19 group showed an increased risk of incident anxiety disorders (hazard ratio 1.35 (95% confidence interval 1.30 to 1.39); risk difference 11.06 (95% confidence interval 9.64 to 12.53) per 1000 people at one year), depressive disorders (1.39 (1.34 to 1.43); 15.12 (13.38 to 16.91) per 1000 people at one year), stress and adjustment disorders (1.38 (1.34 to 1.43); 13.29 (11.71 to 14.92) per 1000 people at one year), and use of antidepressants (1.55 (1.50 to 1.60); 21.59 (19.63 to 23.60) per 1000 people at one year) and benzodiazepines (1.65 (1.58 to 1.72); 10.46 (9.37 to 11.61) per 1000 people at one year). The risk of incident opioid prescriptions also increased (1.76 (1.71 to 1.81); 35.90 (33.61 to 38.25) per 1000 people at one year), opioid use disorders (1.34 (1.21 to 1.48); 0.96 (0.59 to 1.37) per 1000 people at one year), and other (non-opioid) substance use disorders (1.20 (1.15 to 1.26); 4.34 (3.22 to 5.51) per 1000 people at one year). The covid-19 group also showed an increased risk of incident neurocognitive decline (1.80 (1.72 to 1.89); 10.75 (9.65 to 11.91) per 1000 people at one year) and sleep disorders (1.41 (1.38 to 1.45); 23.80 (21.65 to 26.00) per 1000 people at one year). The risk of any incident mental health diagnosis or prescription was increased (1.60 (1.55 to 1.66); 64.38 (58.90 to 70.01) per 1000 people at one year). The risks of examined outcomes were increased even among people who were not admitted to hospital and were highest among those who were admitted to hospital during the acute phase of covid-19. Results were consistent with those in the historical control group. The risk of incident mental health disorders was consistently higher in the covid-19 group in comparisons of people with covid-19 not admitted to hospital versus those not admitted to hospital for seasonal influenza, admitted to hospital with covid-19 versus admitted to hospital with seasonal influenza, and admitted to hospital with covid-19 versus admitted to hospital for any other cause. Conclusions The findings suggest that people who survive the acute phase of covid-19 are at increased risk of an array of incident mental health disorders. Tackling mental health disorders among survivors of covid-19 should be a priority.

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“…We pre-speci ed a set of outcomes based on prior evidence on the post-acute sequelae of COVID-19 6,7,9-13 . Outcomes were de ned using validated de nitions leveraging information from several data domains including diagnoses, prescription medications, and laboratory test results 6,7,[14][15][16][17][18][19][20] . Incident post-acute sequelae were examined in a cohort with no record of the health condition in the year prior to T 0 .…”

Section: Post-acute Sequelaementioning

confidence: 99%

Long Covid after Breakthrough COVID-19: the post-acute sequelae of breakthrough COVID-19

Al‐Aly¹,

Bowe

2021

Preprint

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The post-acute sequelae of COVID-19 have been described1, but whether breakthrough COVID-19 (that is the disease that ensues following vaccine breakthrough SARS-CoV-2 infection) results in post-acute sequelae is not yet clear. Here we use the national healthcare databases of the US Department of Veterans Affairs to characterize 6-month risks of incident post-acute sequelae in people with breakthrough COVID-19 who survived for at least 30 days after diagnosis. We show that compared to people with no evidence of COVID-19, beyond the first 30 days of illness, people with breakthrough COVID-19 exhibit a higher risk of death and broad array of incident post-acute sequelae in the pulmonary system, as well as extrapulmonary sequelae that include cardiovascular disorders, coagulation disorders, gastrointestinal disorders, general disorders (e.g., fatigue), kidney disorders, mental health disorders, metabolic disorders, musculoskeletal disorders, and neurologic disorders. Our analyses by care setting of the acute phase of the disease show that people who were not hospitalized during the first 30 days after diagnosis with breakthrough COVID-19 exhibit a small but not insignificant increase in risk of death and post-acute sequelae; the risks are further increased in people who were hospitalized during the acute phase of the disease. Our comparative approach shows that people with breakthrough COVID-19 exhibit lower risks of death and post-acute sequelae than people with COVID-19 who were not previously vaccinated for it; and in analyses among individuals who were hospitalized during the acute phase of the disease, people with breakthrough COVID-19 exhibit higher risks of death and post-acute sequelae than people with seasonal influenza. Altogether, our findings show increased risks of death and post-acute sequalae in people with breakthrough COVID-19; the risks are evident among those who were not hospitalized during the acute phase of the disease. Our comparative approach provides context for understanding the risks in relation to COVID-19 without prior vaccination and seasonal influenza. The findings will inform the ongoing effort to optimize strategies for prevention of breakthrough SARS-CoV-2 infections and will guide development and optimization of post-acute care pathways for people with breakthrough COVID-19.

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Comparative Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors vs Sulfonylureas in Patients With Type 2 Diabetes

Cited by 39 publications

References 63 publications

Risks and burdens of incident diabetes in long COVID: a cohort study

Risks and burdens of incident diabetes in long COVID: a cohort study

Risks of mental health outcomes in people with covid-19: cohort study

Long Covid after Breakthrough COVID-19: the post-acute sequelae of breakthrough COVID-19

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