Department of Emergency Intensive Care Medicine, Changxing People's Hospital, Changxing County, Huzhou City, Zhejiang Province, China.
Department of Cardiology, Changxing People's Hospital, Changxing County, Huzhou City, Zhejiang Province, China.
Diab Vasc Dis Res. 2022 May-Jun;19(3):14791641221093175. doi: 10.1177/14791641221093175.
To compare clinical outcomes in diabetic patients with heart failure managed by insulin with those managed by non-insulin (oral hypoglycemic agents and/or lifestyle modification) based therapy.
PubMed and Scopus databases were searched for studies conducted on diabetic patients with heart failure. Studies were to compare outcomes of patients managed by insulin versus non-insulin therapies.
15 studies were included. Compared to those who were managed using non-insulin therapy, insulin-treated patients had increased risk of all-cause mortality (RR 1.46, 95% CI: 1.14, 1.88) and cardiovascular specific mortality (RR 1.62, 95% CI: 1.33, 1.96). Those managed using insulin also had increased risk of hospitalization (RR 1.45, 95% CI: 1.09, 1.93) and readmission (RR 1.49, 95% CI: 1.32, 1.67). There was no additional risk for stroke (RR 1.07, 95% CI: 0.91, 1.27) or myocardial infarction (MI) (RR 1.10, 95% CI: 0.96, 1.27) between the two groups of patients.
Receipt of insulin among diabetic patients with heart failure was associated with an increased risk of mortality, hospitalization and readmission compared to management using oral hypoglycemic agents and/or lifestyle modification. Such patients should be closely monitored for any adverse events.
比较胰岛素治疗与非胰岛素（口服降糖药和/或生活方式改变）治疗的糖尿病合并心力衰竭患者的临床结局。
检索了 PubMed 和 Scopus 数据库中关于糖尿病合并心力衰竭患者的研究。研究比较了胰岛素与非胰岛素治疗患者的结局。
共纳入 15 项研究。与接受非胰岛素治疗的患者相比，胰岛素治疗的患者全因死亡率（RR 1.46，95%CI：1.14，1.88）和心血管特定死亡率（RR 1.62，95%CI：1.33，1.96）风险增加。接受胰岛素治疗的患者住院（RR 1.45，95%CI：1.09，1.93）和再入院（RR 1.49，95%CI：1.32，1.67）的风险也增加。两组患者的中风（RR 1.07，95%CI：0.91，1.27）或心肌梗死（RR 1.10，95%CI：0.96，1.27）风险无差异。
与使用口服降糖药和/或生活方式改变治疗相比，糖尿病合并心力衰竭患者使用胰岛素治疗与死亡率、住院和再入院风险增加相关。应密切监测此类患者的任何不良事件。
