{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:34:03Z","timestamp":1768923243193,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T00:00:00Z","timestamp":1500595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2017,10]]},"abstract":"\n Aims<\/jats:title>\n \n Certain treatments for type 2 diabetes mellitus cause hypoglycaemia and weight gain, and thus might counteract the benefits of intensive glucose control. We quantify the association of cardiovascular disease (\n CVD<\/jats:styled-content>\n ) outcomes with hypoglycaemia and weight gain among patients with type 2 diabetes treated with sulfonylureas.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n This cohort study included patients from\n J<\/jats:styled-content>\n anuary 2009 through\n D<\/jats:styled-content>\n ecember 2014 who were selected from within a deidentified nationwide electronic health records repository, including multiple provider networks and electronic medical records systems. Hypoglycaemia measures from structured data fields and free text clinical notes were categorized as serious or non\u2010serious. Covariate adjusted Poisson regression analysis was used to assess the association between frequency of hypoglycaemia (by severity), or magnitude of weight change, and incidence of acute myocardial infarction (\n AMI<\/jats:styled-content>\n ), congestive heart failure (\n CHF<\/jats:styled-content>\n ) and stroke.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 143\u2009635 eligible patients, we observed 5669 cases of\n AMI<\/jats:styled-content>\n , 14\u2009109 incident cases of\n CHF<\/jats:styled-content>\n and 7017 cases of stroke. Overall incidence rates were 1.53, 4.26 and 1.92 per 100 person\u2010years for\n AMI<\/jats:styled-content>\n ,\n CHF<\/jats:styled-content>\n and stroke, respectively. The associations between overall hypoglycaemia and each of the\n CVD<\/jats:styled-content>\n outcomes were positive, with stronger associations observed for serious hypoglycaemia and attenuated or null associations observed for non\u2010serious hypoglycaemia. Weight change exhibited a\n U<\/jats:styled-content>\n \u2010shaped association with increased risks associated with both weight loss and weight gain relative to stable weight.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This study provides evidence of increased\n CVD<\/jats:styled-content>\n risk associated with hypoglycaemia, especially with serious hypoglycaemia events. While associations were attenuated with non\u2010serious hypoglycaemia, the results were suggestive of a potential increased risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.13000","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T02:32:17Z","timestamp":1494556337000},"page":"1425-1435","source":"Crossref","is-referenced-by-count":49,"title":["Hypoglycaemia seriousness and weight gain as determinants of cardiovascular disease outcomes among sulfonylurea users"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9102-3600","authenticated-orcid":false,"given":"Anthony P.","family":"Nunes","sequence":"first","affiliation":[{"name":"Optum Epidemiology Boston Massachusetts"},{"name":"Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy","family":"Iglay","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Kenilworth New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Radican","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Kenilworth New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4439-6356","authenticated-orcid":false,"given":"Samuel S.","family":"Engel","sequence":"additional","affiliation":[{"name":"Merck & Co., Inc. Kenilworth New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"Optum Epidemiology Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael C.","family":"Doherty","sequence":"additional","affiliation":[{"name":"Optum Epidemiology Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David D.","family":"Dore","sequence":"additional","affiliation":[{"name":"Optum Epidemiology Boston Massachusetts"},{"name":"Department of Health Services, Policy and Practice Brown University School of Public Health Providence Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-6-200409210-00007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-2082"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S58781"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.6.1902"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.5.1245"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2008.00882.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2012.01674.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.12.2948"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4533"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2012.0031"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2009.09.2056"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-014-0473-5"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.12.3.203"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/2251-6581-11-17"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.09.012"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-8-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0916"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003795"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802743"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808431"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.03.018"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2012.05.002"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01501.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0126427"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0599-y"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.01072.x"},{"key":"e_1_2_6_28_1","first-page":"186","article-title":"Assessment 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