NIH Public Access Author Manuscript J Endocrinol Diabetes Obes. Author manuscript; available in PMC 2014 December 12.

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Published in final edited form as: J Endocrinol Diabetes Obes. 2014 ; 2(2): .

Frailty Attenuates the Impact of Metformin on Reducing Mortality in Older Adults with Type 2 Diabetes Chen-Pin Wang1,2,*, Carlos Lorenzo3, and Sara E Espinoza3,4,5,6 1Department

of Epidemiology & Biostatistics, University of Texas Health Science Center at San Antonio, USA

2Audie

L Murphy Veterans Hospital, South Texas Veterans Health Care System, USA

3Department

of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, USA 4Department

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of Medicine, Division of Geriatrics, Gerontology, and Palliative Medicine, University of Texas Health Science Center at San Antonio, USA 5Geriatric

Research Education and Clinical Center, Audie L Murphy Veterans Hospital, USA

6Barshop

Institute for Longevity and Aging Studies, USA

Abstract Objective—To determine whether the protective effect of metformin against death is modified by frailty status in older adults with type 2 diabetes.

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Research Design and Methods—We conducted a cohort study during October 1, 1999– September 30, 2006 among veterans aged 65–89 years old with type 2 diabetes but without history of liver, renal diseases, or cancers, who had sulfonylureas or metformin as the sole antidiabetic drug for ≥180 days. The Cox proportional hazard model was used to compare hazard rates of allcause mortality between the metformin and sulfonylurea users adjusting for the propensity score of metformin use and covariates: age, race/ethnicity, diabetes duration, Charlson comorbidity score, statin use, smoking status, BMI, LDL, and HbA1c. Results—In this cohort of 2,415 veterans, 307 (12.7%) were metformin users, 2,108 (87.3%) were sulfonylurea users, the mean age was 73.7±5.2 years, the mean study period was 5.6±2.3 years, the mean HbA1c at baseline was 6.7±1.0%, 23% had diabetes for ≥10 years, and 43.6% (N=1,048) died during the study period. For patients with and without frailty, the adjusted hazard ratio (HR) of death for metformin vs. sulfonylurea use were 0.92 (95% CI=0.90–1.31, pvalue=0.19) and 0.69 (95% CI = 0.60–0.79, p-value

Frailty Attenuates the Impact of Metformin on Reducing Mortality in Older Adults with Type 2 Diabetes.

To determine whether the protective effect of metformin against death is modified by frailty status in older adults with type 2 diabetes...
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