Identifying diabetogenic drugs using real world health care databases: A Danish and Australian symmetry analysis
Authors' conclusion
We identified 70 drug-diabetes associations, of which 27 were classified as hitherto unknown. Further studies evaluating the hypotheses generated by this work are needed, particularly for the signal for digitalis glycosides.
Study context
- Population
- Individuals aged ≥40 years with a first-ever prescription for any antidiabetic drug 1996–2018, Danish nationwide health registries
- Participants
- 348,996 individuals
- Exposure
- Drug class initiation before vs after first antidiabetic drug prescription
- Outcome
- Sequence ratios (SRs) for all drug class-diabetes combinations; signal = lower bound of 95% CI >1.00
Methodological detailshypothesis-free screening of all drug classes, replication in Australian Pharmaceutical Benefits Scheme 10% data extract
- Hypothesis-free screening of all drug classes
- Replication in Australian Pharmaceutical Benefits Scheme 10% data extract
Main finding
As reported in the abstract
Drug classes generating a diabetogenic signal
- Drug classes investigated
- 386
- Drug classes generating a signal
- 70
- Signals previously known (SIDER database or literature review)
- 43
- New signals
- 27
- New signals replicated in both Danish and Australian data
- 3
Observational data: associations, not effects.
Further findings
Known signals: glucocorticoids and β-blockers (Danish data)
- Glucocorticoids, SR
- 1.67 (1.62-1.72) (95% CI)
- β-blockers, SR
- 1.20 (1.16-1.23) (95% CI)
New signals replicated in Danish and Australian data
- Digitalis glycosides, Danish SR
- 2.15 (2.04-2.27) (95% CI)
- Digitalis glycosides, Australian SR
- 1.76 (1.50-2.08) (95% CI)
- Macrolides, Danish SR
- 1.20 (1.16-1.24) (95% CI)
- Macrolides, Australian SR
- 1.11 (1.06-1.16) (95% CI)
- Inhaled β2-agonists combined with glucocorticoids, Danish SR
- 1.35 (1.28-1.42) (95% CI)
- Inhaled β2-agonists combined with glucocorticoids, Australian SR
- 1.14 (1.06-1.22) (95% CI)
Original publication
Identifying diabetogenic drugs using real world health care databases: A Danish and Australian symmetry analysis. Diabetes Obes Metab. Published 10 February 2023. doi:10.
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