Which medications are you prescribing for T2D?

  • Raval AD & al.
  • J Pharm Pract
  • 20 Dec 2018

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Older type 2 diabetes (T2D) medications still remain the most frequently prescribed.

Why this matters

  • Previous studies examining T2D medication trends are outdated or used limited populations.
  • A recent joint statement advises assessing glycemia control, hypoglycemia risk, weight gain, cardiovascular effects, cost, and patient preferences of T2D medications. 

Study design

  • Data from 2008-2015 Medical Expenditure Panel Survey of diabetes medication utilization among adults with diabetes.
  • Funding: None.

Key results

  • Overall diabetes medication use rose from 81.4% in 2008 to 89.8% in 2012, then stabilized at 87.1% in 2015.
  • Metformin use rose from 47.8% in 2008 to 60.0% in 2014, and stabilized to 59.4% in 2015.
  • Insulin use increased from 22.6% in 2008 to 30.0% in 2015.
  • Sulfonylurea use declined from 36.1% to 28.6% in 2014 and stabilized at 29.1% in 2015, while thiazolidinedione dropped from 21.4% in 2008 to 9.8% in 2015.
  • Use of newer classes increased from 2008 to 2015, including dipeptidyl peptidase-4 inhibitors (6.2%-12.4%) and glucagon-like peptide-1 receptor agonists (2.5%-4.4%).
  • Sodium glucose transporter-2 inhibitor use rose from 0.4% following approval in 2013 to 4.2% in 2015.

Limitations

  • No data on prior treatment failures, glycemic control, or therapy appropriateness.  
  • Inconsistent reporting for individual medications.

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