Abstract
Background
Sepsis is one of the leading causes of hospital mortality, and diabetes is a risk
factor for the development of infections. Although strong evidence has shown an association
between metformin and reduced risk of infections, the risk of developing infections
with newer classes of oral anti-diabetic drugs (OADs) has been less certain. Our study
aims to examine the association between outpatient OAD use and hospital admissions
for infections.
Methods
The study cohort included 1.39 million adults with diabetes utilizing the Veterans
Health Affairs Corporate Data Warehouse. Multivariate logistic regression was used
to estimate the effect of each drug class on hospital admission for infection while
adjusting for covariates.
Results
After adjusting for covariates, those who took metformin during the study period had
3.3% lower odds of hospital admission for infection compared to those who were never
on metformin (OR 0.97, 95% CI 0.95-0.98). OADs that were associated with a statistically
significant increased odds of being admitted included meglitinides (OR 1.22, 95% CI
1.07-1.38), SGLT2 inhibitors (OR 1.16, 95% CI 1.08-1.24), alpha-glucosidase inhibitors
(OR 1.09, 95% CI 1.04-1.15), and DPP4 inhibitors (OR 1.04, 95% CI 1.01-1.06).
Conclusions
Metformin was associated with lower odds of hospital admission for infection while
meglitinides, SGLT2 inhibitors, alpha-glucosidase inhibitors, and DPP4 inhibitors
were associated with higher odds of admission for infection.
Key Indexing Terms
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Article info
Publication history
Published online: January 22, 2022
Accepted:
January 19,
2022
Received:
March 9,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
