Grant: Operating Grant

Diabetes is present in 25-40% of all patients with heart failure and 20-30% of patients die within 1 year. Significant controversy exists on how best to control blood sugars in patients with diabetes and heart failure. Currently, doctors are limited to only a few oral drugs to control blood sugars. Recently, a new oral diabetes medication, sitagliptin, has been marketed in Canada. Initial information strongly suggests sitagliptin has favorable effects on the heart. However, whether these initial benefits result in improved health in real-world patients with diabetes and heart failure is unknown. The goal of our study is to improve the management of people living with heart failure and diabetes. In particular, we want to see whether the newly available drug, sitagliptin, can reduce the need to be hospitalized and increase the number of patients who survive relative to other commonly used medications to control blood sugars in patients with heart failure and diabetes. We have purchased data on approximately fifteen thousand patients living with diabetes and heart failure. Within this data, we have information on the types of drugs they used, other disease conditions, and any tests that their providers may have performed (e.g., kidney tests, cholesterol). We also have all of their complete health care utilization including admissions to hospital and information on patients whom died. Using this information, we will observe differences in the need for hospitalization and the risk of dying for people who used sitagliptin compared to people who did not use sitagliptin over time after accounting for differences in their age, sex, and disease characteristics. Our study will be the first to evaluate sitagliptin in heart failure patients and will help clinicians and patients weigh the risks and benefits of this therapy relative to other oral drugs to lower blood sugars in patients with heart failure and diabetes.