IMPACT OF METFORMIN USE ON HEALTHCARE UTILIZATION AND QUALITY OF LIFE AMONG PATIENTS WITH ASTHMA AND TYPE 2 DIABETES COMORBIDITY

Abstract

Background: Type 2 diabetes has been associated with asthma. Patients with type 2 diabetes have a double risk of asthma compared to patients without it. Adverse asthma outcomes are higher in this population. Metformin, a first-line antidiabetic agent, might be a promising treatment for better asthma control in this population. Objectives: Using a nationally representative sample of the United States population with asthma and type 2 diabetes, this study assessed the differences in sociodemographic, clinical, and behavioral variables between individuals who used metformin and those who did not; evaluated the association between metformin use and healthcare utilization; and identified if there was an association between metformin use and quality of life. Method: A 12-year retrospective cohort of adult patients with asthma and type 2 diabetes using the National Health and Nutrition Examination Survey (NHANES) was utilized. The significant differences in risk factors between study groups were determined. Survey-weighted regression analysis models were utilized to evaluate the association between metformin use and healthcare utilization or quality of life. Results: In a cohort of 174 patients with both diseases, more than one-half were using metformin. There were significant differences in risk factors among study groups. Metformin users had a higher number of asthma-related emergency visits (Odds ratio [OR]: 0.300; 95% confidence interval [95% CI]: 0.007-0.593) and a lower risk of asthma-related medication use (OR: 0.285; 95% CI: 0.151-0.536), without differences in other healthcare utilization variables. Metformin users were less likely to report excellent/ good general health condition than metformin non-users (OR: 0.542; 95% CI: 0.328-0.894). Metformin use was associated with a lower risk of frequent wheezing limited the usual activity (OR: 0.279; 95% CI: 0.123-0.630); and a higher risk of more than one night disturbed because of wheezing (OR: 3.602; 95% CI: 1.277-10.158). Conclusion: In a nationally representative cohort of individuals with asthma and type 2 diabetes, metformin should be continued as first-line therapy in type 2 diabetes; however, it should not be a priority selection to improve asthma outcomes among patients with asthma and type 2 diabetes comorbidity.