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Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation
The purpose of this study was to evaluate the effects of alternative antihyperglycemic therapy after discontinuation of metformin due to documented declining renal function. This retrospective, single-site study evaluated patients who had metformin discontinued between 1 January 1999 and 30 Septembe...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309901/ https://www.ncbi.nlm.nih.gov/pubmed/28270711 http://dx.doi.org/10.2337/ds15-0049 |
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author | Bradley, Jessica N. Edwards, Krystal L. Gunter, Jennifer T. Weideman, Rick A. Kelly, Kevin C. |
author_facet | Bradley, Jessica N. Edwards, Krystal L. Gunter, Jennifer T. Weideman, Rick A. Kelly, Kevin C. |
author_sort | Bradley, Jessica N. |
collection | PubMed |
description | The purpose of this study was to evaluate the effects of alternative antihyperglycemic therapy after discontinuation of metformin due to documented declining renal function. This retrospective, single-site study evaluated patients who had metformin discontinued between 1 January 1999 and 30 September 2013. Medical records were evaluated for documented adverse events, subsequent glycemic control, and costs associated with the alternative therapy. Patients served as their own controls. A total of 179 patients met study entry criteria, and their peak A1C was significantly higher within the year after metformin discontinuation (P <0.001). After the provider added new medications to control patients’ blood glucose, their A1C by the end of the first year after discontinuing metformin was similar to their A1C while taking metformin. Significant weight gain accompanied the use of the medications added to replace metformin, with an average increase of 3.81 kg (P <0.001). Additionally, after discontinuing metformin, more patients experienced hypoglycemia with the addition of other medications to control their blood glucose (P <0.001). As expected, the cost of therapy was significantly higher (P <0.0001) after metformin was discontinued because metformin was generically available, whereas the replacement medications frequently were not. Providers should consider the expanded recommendations for the use of metformin in patients with mild to moderate stable renal dysfunction to help such patients avoid weight gain, hypoglycemia, loss of blood glucose control, and increased costs. |
format | Online Article Text |
id | pubmed-5309901 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-53099012018-02-01 Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation Bradley, Jessica N. Edwards, Krystal L. Gunter, Jennifer T. Weideman, Rick A. Kelly, Kevin C. Diabetes Spectr Feature Articles The purpose of this study was to evaluate the effects of alternative antihyperglycemic therapy after discontinuation of metformin due to documented declining renal function. This retrospective, single-site study evaluated patients who had metformin discontinued between 1 January 1999 and 30 September 2013. Medical records were evaluated for documented adverse events, subsequent glycemic control, and costs associated with the alternative therapy. Patients served as their own controls. A total of 179 patients met study entry criteria, and their peak A1C was significantly higher within the year after metformin discontinuation (P <0.001). After the provider added new medications to control patients’ blood glucose, their A1C by the end of the first year after discontinuing metformin was similar to their A1C while taking metformin. Significant weight gain accompanied the use of the medications added to replace metformin, with an average increase of 3.81 kg (P <0.001). Additionally, after discontinuing metformin, more patients experienced hypoglycemia with the addition of other medications to control their blood glucose (P <0.001). As expected, the cost of therapy was significantly higher (P <0.0001) after metformin was discontinued because metformin was generically available, whereas the replacement medications frequently were not. Providers should consider the expanded recommendations for the use of metformin in patients with mild to moderate stable renal dysfunction to help such patients avoid weight gain, hypoglycemia, loss of blood glucose control, and increased costs. American Diabetes Association 2017-02 /pmc/articles/PMC5309901/ /pubmed/28270711 http://dx.doi.org/10.2337/ds15-0049 Text en © 2017 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0 for details. |
spellingShingle | Feature Articles Bradley, Jessica N. Edwards, Krystal L. Gunter, Jennifer T. Weideman, Rick A. Kelly, Kevin C. Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title | Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title_full | Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title_fullStr | Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title_full_unstemmed | Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title_short | Provider Decisions and Patient Outcomes After Premature Metformin Discontinuation |
title_sort | provider decisions and patient outcomes after premature metformin discontinuation |
topic | Feature Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309901/ https://www.ncbi.nlm.nih.gov/pubmed/28270711 http://dx.doi.org/10.2337/ds15-0049 |
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