Association of Hospitalizations With Randomized Glycemia-Lowering Treatment in GRADE.

Details

• Alternative Title:
  Diabetes Care, 2025, v. 48, no. 7: Association of Hospitalizations With Randomized Glycemia-Lowering Treatment in GRADE.
• Journal Article:
  Diabetes Care
• Personal Author:
  Hsia, Daniel S. ; Younes, Naji ; Ghosh, Alokananda ; Kazemi, Erin J. ; Krause-Steinrauf, Heidi ; Buse, John B. ; Baker, Chelsea ; Brown-Friday, Janet ; Diaz, Elsa ; Diner, Jamie ; Groessl, Erik J. ; Legowski, Elizabeth A. ; Mariash, Cary N. ; Waltje, Andrea H. ; Wexler, Deborah J. ; Martin, Catherine L.
• Corporate Authors:
  for the GRADE Research Group
• Description:
  To compare rates of and risk factors for hospitalizations among Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) participants taking metformin and randomly assigned to insulin glargine U-100, glimepiride, liraglutide, or sitagliptin.
  
  Intention-to-treat (ITT) (N = 5,047) and on-assigned-treatment (AT) (N = 4,830) data sets were used. Baseline differences between those hospitalized versus those not hospitalized were assessed. Kaplan-Meier analysis was used to determine incidence for time to first hospitalization, and log-rank tests were used to determine treatment group differences. Time-to-event analyses were used to examine factors affecting subsequent hospitalization risk.
  
  During GRADE, 1,636 participants (32.4%) were hospitalized at least once and 751 (14.9%) were hospitalized more than once. Hospitalized participants were older, less likely to be Hispanic, more likely to be White, and more likely to have a history of hypertension and had higher baseline BMI. There were no treatment group differences in incidence for time to first hospitalization in the ITT data set (P = 0.148), but a reduced hazard rate was observed for those taking liraglutide versus those taking glimepiride in the AT data set (hazard ratio 0.78 95% CI 0.66, 0.92; P = 0.022). Factors increasing the risk for subsequent hospitalizations included meeting the secondary outcome (HbA1c >7.5%, confirmed), each prior hospitalization, and change from assigned treatment (29%, 41%, and 56% increase in risk, respectively). Assignment to liraglutide versus glimepiride reduced this risk by 13%.
  
  Hospitalizations were common in GRADE, and rates were nearly identical across treatment groups. The small, but significant, reduction in risk for subsequent hospitalizations among participants assigned to liraglutide versus glimepiride may influence treatment decisions in populations similar to GRADE participants.
• Content Notes:
  Author manuscript
• Subjects:
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Blood Glucose
  • Diabetes Mellitus, Type 2
  • Hospitalization
  • Hypoglycemic Agents
  • Insulin Glargine
  More +
• Keywords:
  • diabetes treatment
  • hospitalizations
  • serious adverse events
• Source:
  Diabetes Care, 2025, v. 48, no. 7
• DOI:
  https://doi.org/10.2337/dc24-2839
• ISSN:
  0149-5992 ; 1935-5548
• Pubmed ID:
  40424051
• Pubmed Central ID:
  PMC12178615
• Document Type:
  Text
• Funding:
  UL1 TR000445/TR/NCATS NIH HHSUnited States/ ; U01DK098246/DK/NIDDK NIH HHSUnited States/ ; HL/NHLBI NIH HHSUnited States/ ; UL1 TR002529/TR/NCATS NIH HHSUnited States/ ; UL1 TR002541/TR/NCATS NIH HHSUnited States/ ; UM1 TR004406/TR/NCATS NIH HHSUnited States/ ; UL1 TR000439/TR/NCATS NIH HHSUnited States/ ; P30 DK020541/DK/NIDDK NIH HHSUnited States/ ; UL1 TR002378/TR/NCATS NIH HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; P30 DK020572/DK/NIDDK NIH HHSUnited States/ ; UL1 TR002243/TR/NCATS NIH HHSUnited States/ ; U34-DK-088043/DK/NIDDK NIH HHSUnited States/ ; UL1 TR002345/TR/NCATS NIH HHSUnited States/ ; UL1 TR002548/TR/NCATS NIH HHSUnited States/ ; U34 DK088043/DK/NIDDK NIH HHSUnited States/ ; UL1 TR002537/TR/NCATS NIH HHSUnited States/ ; P30 DK092926/DK/NIDDK NIH HHSUnited States/ ; American Diabetes Association/ ; UL1 TR002535/TR/NCATS NIH HHSUnited States/ ; P30 DK072476/DK/NIDDK NIH HHSUnited States/ ; P30 DK079626/DK/NIDDK NIH HHSUnited States/ ; UL1 TR001409/TR/NCATS NIH HHSUnited States/ ; U01 DK098246/DK/NIDDK NIH HHSUnited States/ ; UL1 TR001449/TR/NCATS NIH HHSUnited States/ ; UL1 TR002489/TR/NCATS NIH HHSUnited States/ ; U54 GM104940/GM/NIGMS NIH HHSUnited States/ ; UL1 TR001108/TR/NCATS NIH HHSUnited States/ ; UL1 TR000170/TR/NCATS NIH HHSUnited States/ ; UL1 TR001102/TR/NCATS NIH HHSUnited States/ ; P30 DK017047/DK/NIDDK NIH HHSUnited States/ ; CC/CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  1288-1294 (15 pdf pages)
• Volume:
  48
• Issue:
  7
• Download URL:
  https://stacks.cdc.gov/view/cdc/261383/cdc_261383_DS1.pdf
• File Type:
  [PDF - 486.32 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:400e67d3916d66ebbc1d5277bfac3d1c64d21597457c2975d2bdbd12c2a8401680d932d5105186e0e54898d2e2b3f7ef95e879f8bae041706d0204ee1cf2588c