Association of Hospitalizations with Randomized Glycemia-Lowering Treatment in the GRADE Study

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 · 年份：2025 · DOI：10.2337/figshare.28898609 · 研究领域：Diabetes Treatment and Management、Diet and metabolism studies、Diabetes and associated disorders

Objective: To compare rates of and risk factors for hospitalizations among 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) datasets were used. Baseline differences between those with vs. without hospitalizations were compared. Kaplan-Meier analysis and log-rank tests were used to determine the incidence of time-to-first hospitalization and treatment group differences, respectively. Time-to-event analyses examined factors affecting subsequent hospitalization risk.Results: During GRADE, 1,636 participants (32.4%) had at least one hospitalization and 751 (14.9%) were hospitalized more than once. Hospitalized participants were older, less likely to be Hispanic, more likely to be White, more likely to have a history of hypertension, and had higher baseline BMI. There were no treatment group differences in the incidence of time-to-first hospitalization in the ITT dataset (p=0.148), but a reduced hazard rate (HR) was observed for those taking liraglutide vs. glimepiride in the AT dataset (HR 0.78, 95% CI [0.66, 0.92]; p=0.022). Factors increasing the risk for subsequent hospitalizations were meeting the secondary outcome (HbA1c >7.5%, confirmed), each prior hospitalization, and change from assigned treatment (29%, 41% and 56...