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Traditional Chinese Medical Care and Incidence of Stroke in Elderly Patients Treated with Antidiabetic Medications

1
Department of Chinese Medicine, Dalin Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
2
Department of Chinese Medicine, Taipei City Hospital Zhongxing Branch, Taipei 10341, Taiwan
3
Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
4
Department of Sport and Health Management, Da-Yeh University, Changhua 51591, Taiwan
5
Department of Chinese Medicine, Show Chwan Memorial Hospital, Changhua 50008, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2018, 15(6), 1267; https://doi.org/10.3390/ijerph15061267
Received: 5 May 2018 / Revised: 4 June 2018 / Accepted: 13 June 2018 / Published: 15 June 2018
Objectives: Experimental research has shown that herbal and traditional Chinese medicines (TCM) may serve as complements to Western medicine treatments in the control of blood glucose and cardiovascular complications, but population-based studies are limited. We investigated the association between TCM use and subsequent risk of stroke in older patients with diabetes. Study design: The database used in this cohort study contained longitudinal medical claims for one million subjects randomly selected among beneficiaries of a universal health care program in Taiwan. We identified a cohort of patients with diabetes aged 65 years and older who initiated anti-diabetic medications from 2000 to 2012. Patients who had at least two TCM outpatient visits after their initiation of anti-diabetic medications were considered TCM users. Main outcome measures: The incidence of stroke was measured until 2013. Cox regression models with TCM use as a time-dependent variable were used to calculate the adjusted hazard ratios (HRs) comparing TCM use with no use. Results: Over the 13-year period, 17,015 patients were identified; 4912 (28.9%) of them were TCM users. The incidence of stroke during the follow-up (per 1000 person-years) was 22.8 in TCM users and 25.7 in non-users. TCM users had an adjusted HR of 0.93 for the incidence of ischemic stroke (95% confidence interval [CI] 0.83, 1.04) and of 0.89 for developing hemorrhagic stroke (95% CI 0.66, 1.19), compared with non-users. Conclusions: In this study, in older patients receiving Western medicine treatments for diabetes, TCM use was not associated with an increased risk of developing ischemic stroke and hemorrhagic stroke. View Full-Text
Keywords: diabetes; stroke; traditional Chinese medicine diabetes; stroke; traditional Chinese medicine
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Chiao, Y.-W.; Chen, Y.-J.; Kuo, Y.-H.; Lu, C.-Y. Traditional Chinese Medical Care and Incidence of Stroke in Elderly Patients Treated with Antidiabetic Medications. Int. J. Environ. Res. Public Health 2018, 15, 1267.

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