Cardiovascular drug use and hospitalizations attributable to type 2 diabetes

OBJECTIVE - To investigate cardiovascular drug use and hospitalizations attributable to type 2 diabetes from I year before until 6 years after the start of oral antidiabetic therapy.RESEARCH DESIGN AND METHODS - In this cohort study, 2,584 patients With type 2 diabetes were selected from the PHARMO Record Linkage System, comprising pharmacy records and hospitalizations for all 320,000 residents of six Dutch Cities. Patients with type 2 diabetes were identified as incident oral antidiabetic drug users between 1992 and 1997, Nondiabetic subjects were 1:1-matched for age, sex, pharmacy, and index date and received no insulin, oral antidiabetic drugs, or glucose-testing supplies,RESULTS - Patients with type 2 diabetes were more likely to use cardiovascular drugs (RR 1.28 [95% CI 1.23-1.34]) and to be hospitalized because of cardiovascular diseases (1.54 [1.33-1.78]) after the start of oral antidiabetic therapy than nondiabetic subjects, Differences between patients with type 2 diabetes and nondiabetic subjects lessened from I year before until 6 years after the start of oral antidiabetic therapy, reflected by decreasing attributable risks lot, diuretics, beta -blockers, calcium channel blockers, and cardiac and antithrombotic drugs. The difference in use of angiotensin-converting enzyme inhibitors and lipid-lowering drugs increased. Cardiovascular hospitalizations attributable to type 2 diabetes were similar to 50% in the years close to the start of oral antidiabetic treatment and decreased to similar to 33% in the following),cars.CONCLUSIONS - Although cardiovascular drug use and hospitalizations remained increased in patients with type 2 diabetes after the start of oral antidiabetic therapy, cardiovascular drug use attributable to type 2 diabetes decreased after the start of oral antidiabetic therapy, especially beta -blockers, whereas cardiovascular hospitalizations First decreased and then stabilized.