Association of Hospitalizations With Randomized Glycemia-Lowering Treatment in GRADE

作者：Daniel S. Hsia, Naji Younes, Alokananda Ghosh, Erin J. Kazemi, Heidi Krause‐Steinrauf, John B. Buse, Chelsea Baker, Janet Brown-Friday, Elsa Diaz, Jamie Diner, Erik J. Groessl, Elizabeth A. Legowski, Cary N. Mariash, Andrea Waltje, Deborah J. Wexler, Catherine L. Martin, J.P. Crandall, M. Diane McKee, S. Behringer-Massera, J. Brown-Friday, E. Xhori, K. Ballentine-Cargill, S. Duran, H. Estrella, S. Gonzalez de la torre, J. Lukin, L.S. Phillips, Elizabeth Burgess, Darin E. Olson, Moo‐Yong Rhee, Philip Wilson, T.S. Raines, James E. Boers, J. Costello, M. Maher-Albertelli, R. Mungara, L. Savoye, C.A. White, C. Gullett, L. Holloway, F. Morehead, S. Person, M. Sibymon, S. Tanukonda, C. Adams, Alyson Ross, A. Balasubramanyam, Ruchi Gaba, E. Gonzalez Hattery, A. Ideozu, J. Jimenez, G. Montes, C. Wright, P. Hollander, Esther Roé, A. Jackson, A. Smiley, P. Burt, L. Estrada, K. Chionh, F. Ismail-Beigi, C. Falck-Ytter, L. Sayyed Kassem, A. K. Sood, M. Tiktin, T. Kulow, C. Newman, K.A. Stancil, B. Cramer, J. Iacoboni, M.V. Kononets, C. Sandsers, Lisa Tucker, A. Werner, A. Maxwell, G. McPhee, Chandni Patel, L. Colosimo, Aleksandra Król, Robin Goland, J. Pring, L. Alfano, P. Kringas, C. Hausheer, J. Tejada, K. Gumpel, A. Kirpitch, H. Schneier, J.B. Green, H. AbouAssi, R. Chatterjee, M.N. Feinglos, J. English Jones, S.A. Khan, J.B. Kimpel, R.P. Zimmer, Merrick L. Furst, B.M. Satterwhite, C.R. Thacker, K. Evans Kreider, C.N. Mariash, K.J. Mather, H.M. Ismail, A. Lteif, M. Mullen, T. Hamilton, Neha Patel, G. Riera, Merry Jackson, V. Pirics, D. Aguillar, D. Howard, Stephen D. Hurt, R. Bergenstal, Alexander Carlson, Thomas Martens, Mark W. Johnson, Richard J. Hill, J. Hyatt, C. Jensen, M. Madden, Dianna C. Martin, H. Willis, W. Konerza, S. Yang, K. Kleeberger, R. Passi, S. Fortmann, M. Herson, K. Mularski, Harry Glauber, J. Prihoda, B. Ash, C. Carlson, P.A. Ramey, E. Schield, B. Torgrimson-Ojerio, K. Arnold, B. Kauffman, E. Panos, S. Sahnow, K. Bays, K. Berame, Jennifer Cook, D. Ghioni, J. Gluth, K. Schell, J. Criscola, C. Friason, Suzi Jones, С. А. Назаров, J. Barzilay, N. Rassouli, R. Puttnam, B. Ojoawo, R. Nelson, Michelle Curtis, B. Hollis, C. Sanders-Jones, K. Stokes, Z. El-Haqq, A. Kolli, Thao Tran, D. Wexler, Mary Larkin, James B. Meigs, B. Chambers, A. Dushkin, G. Rocchio, Manuel Yepes, Barbara Steiner, H. Dulin, M. Cayford, Kon Chu, A. DeManbey, M. Hillard, Kimberly Martin, N. Thangthaeng, L. Gurry, R. Kochis, E. Raymond, V. Ripley, Christine Stevens, Jaebum Park, Vanita R. Aroda, Ahmed Ghazi, Michelle Magee, A. Ressing, A. Loveland, Michael W. Hamm, Maria D. Hurtado, Alexander Kuhn, J. Leger, L. Manandhar, F. Mwicigi, O. Sanchez, T. Kue Young, Rajesh Garg, V. Lagari-Libhaber, H.J. Florez, W.M. Valencia, Jennifer B. Marks, Sabina Casula, L. Oropesa-Gonzalez, Louis Hue, A. Cuadot, R. Nieto-Martinez, A.K. Riccio Veliz, M. Gutt, Y.J. Kendal, B. Veciana, A. Ahmann, D. Aby-Daniel, F. Joarder, V. Morimoto, C. Sprague, Daisuke Yamashita, Nathaniel C. Cady, N. Rivera-Eschright, P. Kirchhoff, B. Morales Gomez, J. Adducci, A. Goncharova, S.H. Hox, Helen Petrovitch, M. Matwichyna, Victoria Jenkins, L. Broadwater, R.R. Ishii, N.O. Bermudez, D.S. Hsia, W.T. Cefalu, F.L. Greenway, C. Waguespack, E. King, G. Fry, A. Dragg, B. Gildersleeve, J. Arceneaux, Natalie Haynes, A. Thomassie, M. Pavlionis, B. Bourgeois, C. Hazlett, Sunder Mudaliar, Robert R. Henry, S. Boeder, Jeremy Pettus, E. Diaz, D. Garcia-Acosta, S. Maggs, C. DeLue, A. Stallings, E. Castro, S. Hernandez, Jonathan Krakoff, J.M. Curtis, Tina Killean, Mohammed Khalid, E. Joshevama, E. Diaz, Dianna C. Martin, K. Tsingine, T. Karshner, Jeanine Albu, F.X. Pi-Sunyer, S. Frances, C. Maggio, Elizabeth Ellis, J. Bastawrose, Xiuqun Gong, M.A. Banerji, Phyllis August, Melissa Lee, Daniel Lorber, N.M. Brown, D.H. Josephson, L.L. Thomas, M. Tsovian, A. Cherian, M.H. Jacobson, M.M. Mishko, M.S. Kirkman, J.B. Buse, Jamie Diner, Jean M. Dostou, S. Machineni, Laura Young, K. Bergamo, A. Goley, John Kerr, J.F. Largay, S. Guarda, J. Cuffee, D. Culmer, R. Fraser, H. Almeida, S. Coffer, E. Debnam, L. Kiker, Sarah U. Morton, K. Josey, G. Fuller, W.T. Garvey, A.L. Cherrington, Debra S. Dyer, M.C.R. Lawson, O. Griffith, A. Agne, S. McCullars, Robert M. Cohen, J. Craig, M.C. Rogge, Kathryn Burton, K. Kersey, Charlton Wilson, S. Lipp, M.B. Vonder Meulen, C. Adkins, T. Onadeko, Neda Rasouli, Charles Baker, E. Schroeder, M. Razzaghi, Corey Lyon, R. Penaloza, C. Underkofler, R. Lorch, S. Douglass, S. Steiner, W.I. Sivitz, E. Cline, L.K. Knosp, J. McConnell, Tao L. Lowe, W. H. Herman, R. Pop-Busui, Meng H. Tan, Catherine L. Martin, A. Waltje, A. Katona, L. Goodhall, R. Eggleston, Shihchen Kuo, S. Bojescu, S. Bule, N. Kessler, E. LaSalle, K. Whitley, Elizabeth R. Seaquist, A. Bantle, T. Harindhanavudhi, Anjali Kumar, B. Redmon, John P. Bantle, Manuela Coe, Mario Mech, A. Taddese, K. Lesne, Shannon D. Smith, Cyrus Desouza, L. Kuechenmeister, Vijay Shivaswamy, S. Burbach, M.G. Rodriguez, K. Seipel, A. Alfred, A.L. Morales, J. Eggert, G. Lord, W. Taylor, R. Tillson, D.S. Schade, A. Adolphe, Mark R. Burge, E. Duran-Valdez, Jean Martínez, A. Bancroft, S. Kunkel, F. Ali Jamaleddin Ahmad, D. Hernandez McGinnis, B. Pucchetti, E. Scripsick, A. Zamorano, R.A. DeFronzo, E. Cersosimo, M. Abdul-Ghani, C. Triplitt, D. Juarez, M. Mullen, R.I. Garza, H. Verastiqui, K. Wright, Curtiss Puckett, Philip Raskin, Choong Kyun Rhee, S. Abraham, L.F. Jordan, S. Sao, L. Morton, Oliver Smith, L. Osornio Walker, L. Schnurr-Breen, R. Ayala, R.B. Kreymer, D. Sturgess, K.M. Utzschneider, S.E. Kahn, L. Alarcon-Casas Wright, Edward J. Boyko, E.C. Tsai, D.L. Trence, S. Trikudanathan, B.N. Fattaleh, B.K. Montgomery, K.M. Atkinson, A. Kozedub, T. Concepcion, C. Moak, N. Prikhodko, S. Rhothisen, T.A. Elasy, S. Martin, L. Shackelford, R. Goidel, N. Hinkle, C. Lovell, John Myers, J. Lipps Hogan, J.B. McGill, M. Salam, T. Schweiger, S. Kissel, C. Recklein, M.J. Clifton, W. Tamborlane, Andrew Camp, B. Gulanski, S.E. Inzucchi, K. Pham, M. Alguard, P. Gatcomb, K. Lessard, M.J. Rubio Pérez, L. Iannone, E. Magenheimer, A. Montosa, J. Fradkin, Henry B. Burch, Andrew A. Bremer, D.M. Nathan, J.M. Lachin, H. Krause-Steinrauf, N. Younes, Ionut Bebu, Nicole M. Butera, C.J. Buys, Anne M. Fagan, Ying Gao, Amerta Ghosh, M.R. Gramzinski, S.D. Hall, Elham Kazemi, Elizabeth Legowski, H. Liu, C. Suratt, Mark Tripputi, A. Arey, M. Backman, J. Bethepu, Christian Lund, P. Mangat Dhaliwal, Paula McGee, E. Mesimer, Long Ngo, Michael W. Steffes, Jesse C. Seegmiller, Amy K. Saenger, Valerie Arends, D. Gabrielson, T. Conner, S. Warren, John Day, J. Huminik, A. Scrymgeour, Elsayed Z. Soliman, Yashashwi Pokharel, Z.M. Zhang, Colin Campbell, Jingbo Hu, Lisa Keasler, S. Hensley, Y. Li, R. Mihalcea, D.J. Min, V. Perez-Rosas, Lisa A. Prosser, L. Resnicow, W. Ye, Hui Shao, Ping Zhang, J. Luchsinger, D. Sanchez, Stephanie Assuras, E. Groessl, F. Sakha, H. Chong, N. Hillery, I. Abdouch, G. Bahtiyar, P. Brantley, F.E. Broyles, G. Canaris, Paul M. Copeland, J.J. Craine, W.L. Fein, A. Gliwa, L. Hope, Myeong Soo Lee, R. Meiners, V. Meiners, H. O’Neal, J.E. Park, A. Sacerdote, E. Sledge, L. Soni, J. Steppel-Reznik, Alexander Turchin · 发表于：Diabetes Care · 年份：2025 · DOI：10.2337/dc24-2839 · 研究领域：Diabetes Treatment and Management、Diabetes, Cardiovascular Risks, and Lipoproteins、Hyperglycemia and glycemic control in critically ill and hospitalized patients

OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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 hospitaliz...