Concomitant Use of Sulfonylureas and β-Blockers and the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
Main finding · Severe hypoglycemiaResult — go to the resultHazard ratio 1.53 95% CI 1.42–1.65Authors' conclusion
β-blockers could further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. β-blocker cardioselectivity did not seem to play a major role in this regard.
Study context
- Population
- Patients with T2D initiating sulfonylureas 1998–2020, without β-blocker use in past 6 months, UK Clinical Practice Research Datalink Aurum; mean age 61.3 years, 43% female
- Participants
- 252,869 SU initiators
- Exposure
- Concomitant sulfonylureas and β-blockers vs sulfonylureas alone
- Outcome
- Severe hypoglycemia (hospitalization with or death resulting from hypoglycemia; ICD-10 E16.0, E16.1, E16.2)
- Follow-up
- Median 7.9 years
Methodological detailsnew-user design, time-dependent Cox models, adjusted for baseline confounders
- New-user design
- Time-dependent Cox models
- Adjusted for baseline confounders
Main finding
Severe hypoglycemia
Hazard ratio
1.53
95% CI 1.42–1.65
SU + β-blockersvs SU alone
HR 1.53 (95% CI 1.42–1.65)
As reported in the abstract
- Crude incidence rate of severe hypoglycemia (whole cohort)
- 7.8 per 1,000 per year
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Severe hypoglycaemia: SU + noncardioselectivevs SU + cardioselective β-blockersNo difference in risk | 0.95 (0.74–1.24) | |
| 0.512Hazard ratio (log scale) |
Crude incidence rate of severe hypoglycaemia (whole cohort) · median follow-up 7.9 years
- Crude incidence rate of severe hypoglycaemia
- 7.8 per 1,000 per year
Original publication
Concomitant Use of Sulfonylureas and β-Blockers and the Risk of Severe Hypoglycemia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study. Diabetes Care. Published 16 December 2022. doi:10.
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