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Type 2 diabetes drug prescription trends reflected in study

By Editor
13th August 2018
Clinical guidance, Guidelines Pharmaceutical Type 2 diabetes

Prescribing patterns for type 2 diabetes have changed “markedly” in the UK since 2000 in line with developments to clinical guidelines and new therapies, a study has found.

Researchers from the London School of Hygiene and Tropical Medicine investigated the changes in prescribing for type 2 diabetes between 2000 and 2017.

New classes of drug have been introduced and guidelines have been updated in this period, with the study, published by BMJ Open, aiming to describe how therapy choice at initiation and first stage of intensification have changed over the 17-year timeframe.

They wanted to explored to what extent prescribing was in accordance with clinical guidelines, including adherence to recommendations regarding kidney function.

The repeated cross-sectional study analysed the records of 280,241 adults initiating treatment with drugs for the condition from 2000 to 2017, harvested from the Clinical Practice Research Datalink.

According to the results, 73 per cent initiated metformin, 15 per cent a sulfonylurea, five per cent with metformin and sulfonylurea dual therapy and seven per cent started other options. By 2017, metformin at initiation was 89 per cent.

Among people with an estimated glomerular filtration rate of ≤30 mL/min/1.73 m2, the most common drug at initiation was a sulfonylurea at 58 per cent. In 2000, sulfonylureas were the predominant drug at the first stage of drug intensification with 87 per cent, but by 2017 this fell to 30 per cent as the use of newer drug classes increased, the researchers said.

In 2017, new prescriptions for dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium/glucose cotransporter-2 inhibitors (SGLT2i) accounted for 42 per cent and 22 per cent of intensification drugs, the study said. Uptake of new classes differs by country with DPP4is and SGLT2is prescribed more in Northern Ireland and Wales than England or Scotland, the results found.

The researchers concluded: “Our findings show markedly changing prescribing patterns for T2DM [type 2 diabetes] between 2000 and 2017, largely consistent with clinical guidelines.”

To access the open access paper, click here.

The award-winning Low Carb Program is “effective” for achieving glycemic control, weight loss and reducing hypoglycaemic medications, a study concluded earlier this summer.

To evaluate its effectiveness a team of researchers reviewed one-year outcomes of the Low Carb Program, with the findings published by the Journal of Medical Internet Research. It was based 1,000 participants randomly selected who had been diagnosed with type 2 diabetes and then followed these people up 12 months on from registering with the platform. The results showed that overall blood sugar control and weight loss had improved, especially for participants who had completed all of the program’s 10 modules.

A total of 26.2 per cent of the 743 participants with a starting HbA1c of 47.5 mmol/mol (6.5 per cent)  or above lowered their HbA1c while taking no glucose-lowering medication or just metformin. Of the people who were on at least one therapy for their type 2 diabetes, 40.4 per cent reduced one or more of their medications.

Comments (1)

  1. Peter Palmer says:

    No mention of controlling T2DM with diet. Why are drugs the 1st option to treat a dietary problem? Drugs, without dietary changes away from low-fat, high carb, take people down a path of declining health and eve more drugs.
    Such a shame.
    Drugs haven’t worked so far. They treat symptoms, not causes.

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