Changes in Use of Glucose-Lowering Drugs From 2006-2013
Increase in metformin, DPP-4 inhibitors, insulin use; decrease in sulfonylureas and thiazolidinediones
WEDNESDAY, Sept. 28, 2016 (HealthDay News) -- For patients with type 2 diabetes mellitus (T2DM), the use of glucose-lowering drugs changed from 2006 to 2013, but glycemic control has not changed, according to a study published online Sept. 22 in Diabetes Care.
Kasia J. Lipska, M.D., from the Yale School of Medicine in New Haven, Conn., and colleagues used claims data from 1.66 million privately insured and Medicare Advantage patients with T2DM to examine use of glucose-lowering medications, glycemic control, and the rate of severe hypoglycemia. The proportions were calculated overall and stratified by age and number of comorbidities.
The researchers observed an increase in use of metformin, dipeptidyl peptidase-4 inhibitors, and insulin, and a decline in use of sulfonylureas and thiazolidinediones, from 2006 to 2013 (all P < 0.001). There was a decline in the proportion of patients with hemoglobin A1c (HbA1c) <7 percent and an increase in the proportion with HbA1c ≥9 percent (both P < 0.001). There was variation in glycemic control based on age; in 2013, there was poor control among 23.3 percent of the youngest and 6.3 percent of the oldest patients. The overall severe hypoglycemia rate remained stable (1.3 per 100 person-years; P = 0.72).
"During the recent eight-year period, the use of glucose-lowering drugs has changed dramatically among patients with T2DM," the authors write. "Overall glycemic control has not improved and remains poor among nearly a quarter of the youngest patients."
Several authors disclosed financial ties to the pharmaceutical, medical device, and health insurance industries.