Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;12(2):146-154.
doi: 10.1111/jdi.13330. Epub 2020 Jul 25.

Persons with type 2 diabetes and high insulin persistence were associated with a lower risk of mortality: A nationwide retrospective cohort study

Fu-Shun Yen  1 , James Cheng-Chung Wei  2   3   4 , Jia-Sin Liu  5 , Chih-Cheng Hsu  5   6   7 , Chii-Min Hwu  8   9
Affiliations

Persons with type 2 diabetes and high insulin persistence were associated with a lower risk of mortality: A nationwide retrospective cohort study

Fu-Shun Yen et al. J Diabetes Investig. 2021 Feb.

Abstract

Aims/introduction: Studies assessing the long-term outcomes of insulin persistence are scant. We compared the risk of all-cause mortality among patients with different degrees of insulin persistence.

Materials and methods: In total, 293,210 patients with type 2 diabetes mellitus undergoing insulin therapy were enrolled during 2002-2014. Insulin persistence was defined as continual insulin treatment without a 90-day gap of discontinuation in the 2-year observation period. Mortality rates were compared between 111,220 patients with ≥90% insulin persistence and 111,220 matched patients with <90% insulin persistence during the observational period.

Results: During the mean 5.37-year follow-up period, the mortality rates were 58.26 and 73.21 per 1,000 person-years for patients with ≥90% and <90% of insulin persistence. The adjusted hazard ratio for mortality was 0.80 (95% confidence interval 0.79-0.81, P < 0.001). Patients with high insulin persistence had significantly lower risks than did those with low insulin persistence of death due to hypertension, diabetes, cardiovascular disease, liver disease, kidney disease, respiratory disease, sepsis and cancer.

Conclusions: This study showed that patients with ≥90% insulin persistence were associated with lower risks of all-cause mortality than did patients with <90% insulin persistence.

Keywords: All-cause mortality; Cardiovascular disease; Insulin persistence.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow of selection of cohorts with different insulin persistence from the National Health Insurance Research Database. NHI, National Health Insurance.
Figure 2
Figure 2
Subgroup analysis. Effects of ≥90% versus <90% insulin persistence on all‐cause mortality risks in patients with type 2 diabetes mellitus. AF, atrial fibrillation; CAD, coronary artery disease; CCI, Charlson Comorbidity Index; CHD, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; DCSI, Diabetes Complications Severity Index; PAOD, peripheral artery occlusive disease.
See this image and copyright information in PMC

References

    1. International Diabetes Federation (IDF) Diabetes Atlas . Available from: https://www.idf.org/e‐library/epidemiology‐research/diabetes‐atlas.html Accessed October 14, 2019.
    1. Rao KSS, Kaptoge S, Thompson A, et al Diabetes mellitus, fasting glucose, and risk of cause‐specific death. N Engl J Med 2011; 364: 829–841. - PMC - PubMed
    1. Stratton IM, Adler AI, Neil HA, et al Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405–412. - PMC - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group . UK Prospective Diabetes Study 16. Overview of 6 years therapy of type II diabetes: a progressive disease. Diabetes 1995; 44: 1249–1258. - PubMed
    1. WHO . Essential Medicines and Health Products. Geneva, Switzerland: World Health Organization, 2017. Available from: http://www.who.int/medicines/services/essmedicines_def/en/ Accessed June 14, 2019.

MeSH terms