Jaelim Cho, M.D., M.P.H., from the University of Auckland in New Zealand, and colleagues used nationwide pharmaceutical dispensing data (from 2006 to 2015) linked to hospital discharge data to identify 1,862 individuals with PCRD or PPDM.
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The researchers found that in individuals with PCRD, ever users of metformin (adjusted hazard ratio [aHR], 0.54) and ever users of insulin (aHR, 0.46) had significantly lower risks of mortality versus patients never using antidiabetic medications. However, these associations were weakened with the use of a 6-month lag. In individuals with PPDM, compared with never users of antidiabetic medications, ever users of metformin had a significantly lower risk of mortality(aHR, 0.51; 95 percent confidence interval [CI], 0.36 to 0.70), whereas ever users of insulin did not have a significantly changed risk of mortality (aHR, 0.75; 95 percent CI, 0.49 to 1.14). Even with a 6-month lag, the association between metformin use and mortality risk remained significant.
“Reverse causality may play a role in the association between insulin use and mortality in PCRD,” write the authors.
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