• Media type: E-Article
  • Title: Trends in First-Line Glucose-Lowering Drug Use in Adults With Type 2 Diabetes in Light of Emerging Evidence for SGLT-2i and GLP-1RA
  • Contributor: Shin, HoJin; Schneeweiss, Sebastian; Glynn, Robert J.; Patorno, Elisabetta
  • Published: American Diabetes Association, 2021
  • Published in: Diabetes Care, 44 (2021) 8, Seite 1774-1782
  • Language: English
  • DOI: 10.2337/dc20-2926
  • ISSN: 0149-5992; 1935-5548
  • Origination:
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  • Description: OBJECTIVE We evaluated recent use trends and predictors of first-line antidiabetes treatment in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult patients with type 2 diabetes who initiated antidiabetes treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetes treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetes treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent. RESULTS Metformin was the most frequently initiated medication, used by 80.6% of Medicare beneficiaries and 83.1% of commercially insured patients. Sulfonylureas were used by 8.7% (Medicare) and 4.7% (commercial). Both populations had low use of sodium–glucose cotransporter 2 inhibitors (SGLT-2i, 0.8% [Medicare] and 1.7% [commercial]) and glucagon-like peptide 1 receptor agonists (GLP-1Ra; 1.0% [Medicare] and 3.5% [commercial]), with increasing trends over time (P < 0.01). Initiators of antidiabetes drugs with established cardiovascular benefits (SGLT-2i and GLP-1RA) were more likely to be younger and had prevalent CVD or higher socioeconomic status compared with initiators of metformin. CONCLUSIONS Among adult patients with type 2 diabetes, metformin was by far the most frequent first-line treatment. While the use of SGLT-2i and GLP-1RA was low from 2013 through 2019, it increased among patients with CVD.
  • Access State: Open Access