Type 2 diabetes mellitus is common in patients undergoing dialysis. However, the association between anti-diabetic drug use and survival outcomes is rarely discussed. We aimed to investigate whether continued anti-diabetic medication use affects the survival of diabetic dialysis patients and whether different hypoglycemic drug use influences prognosis. Using a nationwide database, we enrolled patients with incident end-stage renal disease under maintenance dialysis during 2011–2015 into the pre-existing diabetes dialysis (PDD), incident diabetes after dialysis (IDD), and non-diabetic dialysis (NDD) groups. The PDD group was further subclassified into patients who continued (PDD-M) and discontinued (PDD-NM) anti-diabetic drug use after dialysis. A total of 5249 dialysis patients were examined. The PDD-NM group displayed a significantly higher mortality rate than the IDD, PDD-M, and NDD groups (log-rank test P < 0.001). The PDD-M group had a significantly lower risk of death, regardless of insulin (P < 0.001) or oral hypoglycemic agent (OHA) (P < 0.001) use. Initial insulin administration or OHA had no statistically significant effect on overall mortality in the IDD group. But OHA use had better survival trends than insulin administration for the older (P = 0.02) and male subgroups (P = 0.05). For dialysis patients with diabetes, continuous administration of anti-diabetic drugs after dialysis and choice of medication may affect outcomes.

中文翻译：

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抗糖尿病药物对糖尿病透析患者的影响：全国回顾性队列研究

2 型糖尿病在接受透析的患者中很常见。然而，很少讨论抗糖尿病药物的使用和生存结果之间的关联。我们的目的是研究持续使用抗糖尿病药物是否会影响糖尿病透析患者的生存以及不同降糖药物的使用是否会影响预后。我们使用全国数据库，将 2011 年至 2015 年期间发生维持性透析的终末期肾病患者纳入既往糖尿病透析 (PDD)、透析后发生糖尿病 (IDD) 和非糖尿病透析 (NDD) 组。PDD组进一步细分为透析后继续使用抗糖尿病药物的患者（PDD-M）和停止使用抗糖尿病药物的患者（PDD-NM）。总共对 5249 名透析患者进行了检查。PDD-NM 组的死亡率显着高于 IDD、PDD-M 和 NDD 组（对数秩检验 P < 0.001）。无论使用胰岛素 (P < 0.001) 还是口服降糖药 (OHA) (P < 0.001)，PDD-M 组的死亡风险均显着降低。初始胰岛素给药或 OHA 对 IDD 组的总体死亡率没有统计学上的显着影响。但对于老年人 (P = 0.02) 和男性亚组 (P = 0.05)，使用 OHA 的生存趋势优于注射胰岛素。对于患有糖尿病的透析患者来说，透析后持续服用抗糖尿病药物以及药物的选择可能会影响预后。