Pneumonia, Type 2 Diabetes Mellitus (T2DM)
Conditions
Brief summary
This retrospective observational target-trial emulation uses electronic health record data from the TriNetX US Collaborative Network to compare preadmission glucose-lowering treatment strategies in adults with type 2 diabetes hospitalized with pneumonia. Time zero is the date of the index pneumonia admission. The study compares patients with evidence of prescriptions for both a GLP-1 receptor agonist and an SGLT2 inhibitor in the year before admission with patients prescribed a GLP-1 receptor agonist alone, an SGLT2 inhibitor alone, or usual care. Usual care includes metformin, sulfonylureas, or DPP-4 inhibitors without either study class. The primary outcome is a composite of all-cause death, invasive mechanical ventilation, or renal replacement therapy within 30 days of admission, with the individual components and 12-month mortality, major adverse cardiovascular events, and major adverse kidney events also evaluated. Propensity-score methods are used to reduce bias from nonrandom treatment selection.
Interventions
None listed
Sponsors
Chung Shan Medical University
National Science and Technology Council, Taiwan
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older. * Type 2 diabetes mellitus * Hospitalization with pneumonia during the study period, serving as the index admission * Prescription of a GLP-1 receptor agonist, an SGLT2 inhibitor, or usual-care glucose-lowering therapy in the year before the index admission * No GLP-1 receptor agonist or SGLT2 inhibitor prescription in the 6 months before the first qualifying prescription
Exclusion criteria
* Type 1 diabetes mellitus, or other specified diabetes types that are not type 2 diabetes * Human immunodeficiency virus infection * Bariatric surgery * Solid-organ transplantation * Pneumonia hospitalization, invasive mechanical ventilation, or renal replacement therapy in the year before the index admission * End-stage kidney disease, dialysis dependence, ventilator dependence, or tracheostomy status * Metastatic malignancy, lung cancer, or palliative care * Viral pneumonia, influenza with pneumonia, or COVID-19 around the index admission * Acute cardiovascular event in the 6 months before the index admission
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Composite outcome (all-cause mortality, invasive mechanical ventilation, or renal replacement therapy) | Within 30 days after the index pneumonia admission |
Secondary
| Measure | Time frame |
|---|---|
| All-cause mortality | Within 30 days after the index pneumonia admission |
| Invasive mechanical ventilation | Within 30 days after the index pneumonia admission |
| Renal replacement therapy | Within 30 days after the index pneumonia admission |
| Composite outcome (all-cause mortality, major adverse cardiovascular events, or major adverse kidney events) | Through 12 months after the index pneumonia admission |
| Major adverse cardiovascular events | Through 12 months after the index pneumonia admission |
| Major adverse kidney events | Through 12 months after the index pneumonia admission |
Countries
Taiwan
Contacts
CONTACTPen-Hua Su, PhD
CONTACTYu-Nan Huang, PhD
Outcome results
None listed