Metformin and Thiazolidinedione Use in Medicare Patients With Heart Failure

Abstract

Context According to package inserts, metformin is contraindicated in diabetic patients receiving drug treatment for heart failure therapy, and thiazolidinediones are not recommended in diabetic patients with symptoms of advanced heart failure. Little is known about patterns of use of these antihyperglycemic drugs in diabetic patients with heart failure. Objective To determine the proportions of patients hospitalized with heart failure and concomitant diabetes treated with metformin or thiazolidinediones. Design Serial cross-sectional measurements using data from retrospective medical record abstraction. Setting Nongovernmental acute care hospitals in the United States. Patients Two nationally representative samples of Medicare beneficiaries hospitalized with the primary diagnosis of heart failure and concomitant diabetes between

Management of newly treated diabetes in Medicare beneficiaries with and without heart failure

“…Previous studies compared DM medication use in patients with and without HF. In a study of Medicare beneficiaries from 2000 to 2001, only 11.2% of patients received metformin at the time of discharge from a HF hospitalization, whereas 16.1% of patients received a thiazolidinedione . In our contemporary study of patients with newly treated DM, patients with chronic HF had higher rates of metformin use and lower rates of thiazolidinedione use compared with prior studies.…”

Medicine utilization review at a university teaching hospital in New Delhi

“…Among the antidiabetic agents, metformin consumption was comparatively higher in our study in comparison to the data of Masoudi et al . [19] However it was lower than reported by Baccuzi et al . [20] Metformin is contraindicated in all patients with heart failure requiring the pharmacological treatment because of the increased risk of potentially lethal lactic acidosis.…”

Metformin: Non-Glycemic Effects and Potential Novel Indications

“…patients compared with people who were not taking metformin (71). A recent prospective observational study of nearly 20,000 people with diabetes showed similar findings (8).…”