Risk of Lactic Acidosis in Hospitalized Diabetic Patients Prescribed Biguanides in Japan: A Retrospective Total-Population Cohort Study

Takako Mohri, Sawako Okamoto (), Yuichi Nishioka, Tomoya Myojin, Shinichiro Kubo, Tsuneyuki Higashino, Sadanori Okada, Yasuhiro Akai, Tatsuya Noda, Hitoshi Ishii and Tomoaki Imamura
Additional contact information
Takako Mohri: Department of Diabetes and Endocrinology, Nara Medical University Hospital, Nara 634-8522, Japan
Sawako Okamoto: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan
Yuichi Nishioka: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan
Tomoya Myojin: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan
Shinichiro Kubo: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan
Tsuneyuki Higashino: Healthcare and Wellness Division, Mitsubishi Research Institute Inc., Tokyo 100-8141, Japan
Sadanori Okada: Department of Diabetes and Endocrinology, Nara Medical University Hospital, Nara 634-8522, Japan
Yasuhiro Akai: Department of Community-Based Medicine, Nara Medical University, Nara 634-8521, Japan
Tatsuya Noda: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan
Hitoshi Ishii: Department of Doctor-Patient Relationships, Nara Medical University, Nara 634-8521, Japan
Tomoaki Imamura: Department of Public Health, Health Management and Policy, Nara Medical University, Nara 634-8521, Japan

IJERPH, 2023, vol. 20, issue 7, 1-12

Abstract: Patient data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) are used to assess the effect of biguanide administration on rates of lactic acidosis (LA) in hospitalized diabetes mellitus (DM) patients. In this retrospective cohort study (from April 2013 to March 2016), we compare DM inpatients prescribed biguanides to DM inpatients who were not prescribed biguanides to quantify the association between biguanides and incidence of LA. In total, 8,111,848 DM patient records are retrieved from the NDB. Of the 528,768 inpatients prescribed biguanides, 782 develop LA. Of the 1,967,982 inpatients not prescribed biguanides, 1310 develop LA. The rate ratio of inpatients who develop LA and are administered biguanides to those who developed LA without receiving biguanides is 1.44 (95% CI, 1.32–1.58). Incidence rates and rate ratios for both sexes are elevated in the group prescribed biguanides for patients aged 70 years and older, markedly in those 80 years and older: 40.12 and 6.31 (95% CI, 4.75–8.39), respectively, for men and 34.96 and 5.40 (95% CI, 3.91–7.46), respectively, for women. Biguanides should be used conservatively in patients older than 70 years, particularly for those with comorbidities, and with caution in patients 80 years and older.

Keywords: lactic acidosis; biguanides; diabetes mellitus; population-based database; retrospective cohort study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/7/5300/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/7/5300/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:7:p:5300-:d:1110122

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().