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Supplementary Tables and Figures SUPPLEMENTARY DATA Supplementary Table 1. Antidepressants tested in this study Serotonin and Tricyclic Tetracyclic Selective serotonin norepinephrine antidepressants antidepressants reuptake inhibitors Other antidepressants reuptake inhibitors (TCAs) (TTAs) (SSRIs) (SNRIs) Name Converted dose Name Converted dose Name Converted dose Name Converted dose Name Converted dose Amitriptyline 150 Maprotiline 150 Fluvoxamine 150 Milnacipran 100 Mirtazapine (NaSSA) 30 Amoxapine 150 Mianserin 60 Paroxetine 40 Duloxetine 30 Sulpiride 300 Clomipramine 120 Setiptiline 6 Sertraline 100 Venlafaxine 150 Trazodone 300 Dosulepine 150 Escitalopram 20 Imipramine 150 Lofepramine 150 Nortriptyline 75 Trimipramine 150 NaSSA, noradrenergic and specific serotonergic antidepressant ©2020 American Diabetes Association. Published online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc19-1175/-/DC1 SUPPLEMENTARY DATA Supplementary Table 2. Combination of antidepressants and the risk of type 2 diabetes mellitus onset Without With diabetes diabetes Cox proportional hazards model onset (n = onset (n = 85305) 5225) n (%) n (%) Person-years Adjusted incidence rate a Adjusted hazard ratio b 95% CI p value Combination of antidepressants Not used (reference category) 41990 (49.2) 3275 (62.7) 407875.08 1.00 TCAs 2320 (2.7) 115 (2.2) 8261.83 1.73 2.33 1.93-2.81 <0.001 TTAs 418 (0.5) 28 (0.5) 1574.75 2.21 2.99 2.06-4.35 <0.001 SSRIs 11245 (13.2) 440 (8.4) 43344.75 1.26 1.59 1.43-1.76 <0.001 SNRIs 2601 (3.0) 106 (2.0) 7665.92 1.72 2.39 1.96-2.91 <0.001 NaSSA 1281 (1.5) 37 (0.7) 3101.50 1.49 2.36 1.70-3.27 <0.001 Sulpiride 7949 (9.3) 241 (4.6) 27885.00 1.08 1.41 1.23-1.61 <0.001 Trazodone 838 (1.0) 39 (0.7) 2606.00 1.86 2.63 1.91-3.62 <0.001 TCAs+TTAs 49 (0.1) 13 (0.2) 282.33 5.73 7.12 4.13-12.3 <0.001 TCAs+SSRIs 976 (1.1) 77 (1.5) 5059.67 1.90 2.28 1.82-2.87 <0.001 TCAs+SNRIs 253 (0.3) 21 (0.4) 1082.42 2.42 3.13 2.04-4.82 <0.001 TCAs+NaSSA 86 (0.1) 6 (0.1) 324.00 2.31 3.36 1.51-7.49 0.003 TCAs+Sulpiride 459 (0.5) 25 (0.5) 2141.83 1.45 1.84 1.24-2.74 0.002 TCAs+Trazodone 83 (0.1) 9 (0.2) 418.75 2.68 3.32 1.72-6.39 <0.001 TTAs+SSRIs 197 (0.2) 19 (0.2) 1000.50 2.37 2.93 1.87-4.60 <0.001 ©2020 American Diabetes Association. Published online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc19-1175/-/DC1 SUPPLEMENTARY DATA TTAs+SNRIs 53 (0.1) 6 (0.1) 234.17 3.19 4.06 1.82-9.05 0.001 TTAs+Sulpiride 106 (0.1) 9 (0.2) 545.92 2.05 2.53 1.32-4.87 0.005 TTAs+Trazodone 44 (0.1) 3 (0.1) 185.58 2.01 2.68 0.87-8.33 0.088 SSRIs+SNRIs 1023 (1.2) 68 (1.3) 4457.08 1.90 2.46 1.93-3.13 <0.001 SSRIs+NaSSA 591 (0.7) 35 (0.7) 2052.25 2.12 3.07 2.19-4.29 <0.001 SSRIs+Sulpiride 3623 (4.2) 132 (2.5) 15209.67 1.08 1.39 1.16-1.65 <0.001 SSRIs+Trazodone 605 (0.7) 36 (0.7) 2647.50 1.69 2.21 1.59-3.07 <0.001 SNRIs+NaSSA 385 (0.5) 17 (0.3) 1157.42 1.83 2.79 1.73-4.51 <0.001 SNRIs+Sulpiride 869 (1.0) 34 (0.7) 3289.42 1.29 1.68 1.20-2.36 0.003 SNRIs+Trazodone 187 (0.2) 15 (0.3) 726.42 2.57 3.53 2.12-5.87 <0.001 NaSSA+Sulpiride 274 (0.3) 9 (0.2) 831.58 1.35 2.07 1.07-4.00 0.03 Sulpiride+Trazodone 325 (0.4) 15 (0.3) 1150.58 1.62 2.26 1.36-3.77 0.002 3 or more antidepressants 6356 (7.5) 393 (7.5) 32640.58 1.50 1.78 1.60-1.98 <0.001 aHazard ratios were adjusted for sex, age, body mass index, smoking status, exercise, alcohol intake, late-evening snack, concomitant conditions, and concomitant medications. CI, confidence interval; NaSSA, noradrenergic and specific serotonergic antidepressant; SNRI, serotonin and norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant; TTA, tetracyclic antidepressant ©2020 American Diabetes Association. Published online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc19-1175/-/DC1 SUPPLEMENTARY DATA Supplementary Figure 1. Flowchart showing patient inclusion and exclusion. ©2020 American Diabetes Association. Published online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc19-1175/-/DC1 SUPPLEMENTARY DATA Supplementary Figure 2. Changes in the mean glycated hemoglobin (HbA1c) levels after diabetes onset in the antidepressant continuation, discontinuation, and dose reduction groups. ©2020 American Diabetes Association. Published online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc19-1175/-/DC1 .
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