Electronic letters to:
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eLetters: Electronic letters published:
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Patient characteristics not described
- Stanley Lofsky (3 April 2006)
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Stanley Lofsky
Send letter to journal:
slofsky{at}sympatico.ca Stanley Lofsky
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Administrative database research is capable of demonstrating trends but is not capable of describing individual patient variables. Many physicians with a new case of diabetes would treat more obese patients initially with metformin, and normal weight patients with glyburide. This research gives us no patient details to corroborate such possible trends. Is the increased mortality with glyburide partially attributable to a more severe insulin deficiency seen with normal weight diabetics, rather than attributable to the type of antidiabetic used? The study did not measure mortality of individuals on dual metformin and glyburide therapy. Thus there was no opportunity to measure any possible protective effect of combined therapy. On a more practical basis, the research may convince physicians to switch to other less common sulfonylureas or thiazolidinediones. For many patients covered by Provincial drug plans, there may be limited access for payment. Provincial drug programs will need to move quickly to accomodate such pressures so as not to cause financial pressures on our patients. |
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