Table 6.
Adjusted hazard ratios (95% confidence intervals) for each outcome (model F) compared with monotherapy with metformin
| Treatments | Adjusted hazard ratio (95% CI) | ||
|---|---|---|---|
| Heart failure | Cardiovascular disease | All cause mortality | |
| Metformin (reference) | 1.00 | 1.00 | 1.00 |
| Monotherapy or no treatment: | |||
| No current treatment | 1.47 (1.40 to 1.53)* | 1.31 (1.27 to 1.35)* | 1.55 (1.52 to 1.59)* |
| Sulphonylureas | 1.47 (1.37 to 1.57)* | 1.31 (1.24 to 1.38)* | 1.93 (1.87 to 2.00)* |
| Insulin | 1.85 (1.61 to 2.12)* | 1.59 (1.41 to 1.80)* | 2.55 (2.41 to 2.71)* |
| Glitazones | 0.74 (0.38 to 1.42)† | 1.03 (0.69 to 1.54)† | 1.38 (1.04 to 1.83)† |
| Gliptins | 1.28 (0.85 to 1.92)† | 1.50 (1.11 to 2.02)* | 1.86 (1.55 to 2.25)* |
| Other diabetes drugs | 1.35 (0.85 to 2.14)† | 1.47 (1.03 to 2.09)* | 1.65 (1.31 to 2.08)* |
| Dual treatment: | |||
| Metformin and sulphonylureas | 1.09 (1.03 to 1.15)* | 0.99 (0.95 to 1.03)† | 0.96 (0.93 to 0.99)† |
| Metformin and insulin | 1.58 (1.36 to 1.83)* | 1.16 (1.03 to 1.32)* | 1.18 (1.07 to 1.31)* |
| Metformin and glitazones | 0.74 (0.58 to 0.93)‡ | 0.60 (0.51 to 0.70)‡ | 0.86 (0.74 to 1.00)† |
| Metformin and gliptins | 0.91 (0.76 to 1.10)† | 0.87 (0.77 to 0.99)‡ | 0.80 (0.71 to 0.91)‡ |
| Metformin and other hypo | 1.08 (0.84 to 1.40)† | 0.96 (0.80 to 1.15)† | 0.72 (0.58 to 0.89)‡ |
| Sulphonylureas and insulin | 1.73 (1.41 to 2.13)* | 1.54 (1.26 to 1.88)* | 2.32 (2.09 to 2.58)* |
| Sulphonylureas and glitazones | 0.95 (0.68 to 1.31)† | 0.99 (0.76 to 1.28)† | 1.50 (1.24 to 1.80)* |
| Sulphonylureas and gliptins | 1.29 (0.96 to 1.72)† | 1.27 (1.00 to 1.60)† | 1.44 (1.23 to 1.68)* |
| Sulphonylureas and other diabetes drugs | 2.13 (1.39 to 3.28)* | 1.33 (0.87 to 2.03)† | 2.07 (1.55 to 2.77)* |
| Triple treatment: | |||
| Metformin, sulphonylureas, and insulin | 1.34 (1.11 to 1.60)* | 1.24 (1.08 to 1.42)* | 1.53 (1.35 to 1.72)* |
| Metformin, sulphonylureas, and glitazones | 0.79 (0.66 to 0.93)‡ | 0.78 (0.70 to 0.87)‡ | 0.68 (0.59 to 0.78)‡ |
| Metformin, sulphonylureas, and gliptins | 0.89 (0.76 to 1.03)† | 0.92 (0.83 to 1.02)† | 0.76 (0.69 to 0.85)‡ |
| Metformin, sulphonylureas, and other diabetes drugs | 0.87 (0.68 to 1.13)† | 0.81 (0.68 to 0.97)‡ | 0.71 (0.58 to 0.88)‡ |
| All other drug combinations | 1.06 (0.86 to 1.29)† | 1.07 (0.94 to 1.23)† | 1.05 (0.91 to 1.22)† |
*Significantly increased.
†Non-significant.
‡Significantly decreased.
Hazard ratios adjusted for: sex; age; calendar year; duration since diagnosis of diabetes (five levels); ethnicity (nine levels); Townsend deprivation score; smoking status (five levels); use of other diabetes drugs, anticoagulant thiazides, angiotensin coverting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, statins, and aspirin; previous complications (blindness, hyperglycaemia, hypoglycaemia, amputation, severe kidney failure); hypertension; cardiovascular disease; atrial fibrillation; chronic renal disease; rheumatoid arthritis; valvular heart disease; peripheral vascular disease; body mass index; systolic blood pressure; haemoglobin A1c; serum creatinine level; cholesterol to high density lipoprotein cholesterol ratio.