Evidence mapPaperPMID 36495141Full record

ArticleJournal of the American Geriatrics Society2023

Comparative safety of sulfonylureas among U.S. nursing home residents.

Andrew R Zullo, Melissa R Riester, Kaleen N Hayes, Medha N Munshi, Sarah D Berry

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Andrew R ZulloDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-1673-4570
Melissa R RiesterDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-2196-0134
Kaleen N HayesDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Medha N MunshiJoslin Diabetes Center, Boston, Massachusetts, USA.
Sarah D BerryBeth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Brown University · USBeth Israel Deaconess Medical Center · USJoslin Diabetes Center · USUniversity of Toronto · CA

Funding

Clinically Significant Drug Interactions among Nursing Home Residents with ADRDR01AG077620 · BROWN UNIVERSITY · 2025 to 2025
$693k
Benefits and Harms of Long-term Osteoporosis Pharmacotherapy: Impact of Treatment Length, Type, Switching, and HolidaysR01AG078759 · BROWN UNIVERSITY · 2025 to 2025
$615k
NIA NIH HHS R01 AG065722NIA NIH HHS R01 AG077620NIA NIH HHS R01 AG078759NIA NIH HHS R21 AG061632NIA NIH HHS RF1 AG061221
6 · The paper itself

Abstract

backgroundThe comparative safety of sulfonylureas (SUs) in nursing home (NH) residents remains understudied despite widespread use. We compared the effects of three SU medications and initial SU doses on adverse glycemic and cardiovascular events among NH residents.

methodsThis national retrospective cohort study linked Medicare claims with Minimum Data Set 2.0 assessments for long-stay NH residents aged ≥65 years between January 2008 and September 2010. Exposures were the SU medication initiated (glimepiride, glipizide, or glyburide) and doses (standard or reduced). One-year outcomes were hospitalizations or emergency department visits for severe hypoglycemia, heart failure (HF), stroke, and acute myocardial infarction (AMI). After the inverse probability of treatment and inverse probability of censoring by death weighting, we estimated hazard ratios (HR) using Cox regression models with robust 95% confidence intervals (CI).

resultsThe cohort (N = 6821) included 3698 new glipizide, 1754 glimepiride, and 1369 glyburide users. Overall, the mean (standard deviation) age was 81.4 (8.2) years, 4816 (70.6%) were female, and 5164 (75.7%) were White non-Hispanic residents. The rates of severe hypoglycemia were 30.3 (95% CI 22.3-40.1), 49.0 (95% CI 34.5-67.5), and 35.9 (95% CI 22.2-54.9) events per 1000 person-years among new glipizide, glimepiride, and glyburide users, respectively (glimepiride versus glipizide HR 1.6, 95% CI 1.0-2.4, p = 0.04; glyburide versus glipizide HR 1.2, 95% CI 0.7-1.9, p = 0.59). The rates of severe hypoglycemia were 27.1 (95% CI 18.6-38.0) and 42.8 (95% CI 33.6-53.8) events per 1000 person-years among new users of reduced and standard SU doses, respectively (HR 2.2, 95% CI 1.4-3.5, p < 0.01). Rates of HF, stroke, and AMI were similar between medications and doses.

conclusionsAmong long-stay NH residents, new use of glimepiride and standard SU doses resulted in higher rates of severe hypoglycemic events. Cardiovascular outcomes may not be affected by the choice of SU medication or dose.

Indexed as

HypoglycemiaMyocardial InfarctionStrokeAgedFemaleGlipizideGlyburideHumansMaleMedicareNursing HomesRetrospective StudiesSulfonylurea CompoundsUnited StatesglimepirideGlipizideGlyburideSulfonylurea Compoundsdiabetes mellitusfrailtynursing homessulfonylurea compounds

Identifiers

PMID36495141
PMCPMC10089954
OpenAlexW4311026396

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.