Ambulatory noninsulin treatment of type 2 diabetes mellitus in the United States, 2015 to 2019.
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ drug therapy
Dipeptidyl-Peptidase IV Inhibitors
/ therapeutic use
Drug Therapy, Combination
Humans
Hypoglycemic Agents
/ therapeutic use
Metformin
/ therapeutic use
Sodium-Glucose Transporter 2 Inhibitors
/ therapeutic use
United States
/ epidemiology
DPP-4 inhibitor
SGLT2 inhibitor
antidiabetic drug
metformin
pharmaco-epidemiology
sulphonylureas
Journal
Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
01
04
2021
received:
16
07
2020
accepted:
02
04
2021
pubmed:
22
4
2021
medline:
7
8
2021
entrez:
21
4
2021
Statut:
ppublish
Résumé
To examine trends in the noninsulin drug treatment of type 2 diabetes, including first- and second-line therapies on top of metformin, from 2015 to 2019. We conducted a descriptive analysis of cross-sectional data using the IQVIA National Disease and Therapeutic Index, a nationally representative audit of ambulatory physician practices in the United States. We focused on the use of noninsulin pharmacological treatments for type 2 diabetes among individuals aged 35 years and older between January 1, 2015 and December 31, 2019. The main outcome was type 2 diabetes visits where a prescription drug was used ("treatment visit"). Ambulatory diabetes visits decreased from 30.1 million treatment visits in 2015 to 29.5 million treatment visits in 2019. Among treatment visits where a single drug was prescribed, the use of metformin declined from 57.0% of monotherapy in 2015 to 46.0% of monotherapy in 2019, while during the same period the share of monotherapy accounted for by glucagon-like peptide-1 (GLP-1) receptor agonists increased from 4.3% to 8.5% and the share accounted for by sodium-glucose cotransporter-2 (SGLT2) inhibitors increased from 7.3% to 19.5%. Among treatment visits where metformin plus another drug was prescribed, the share of second-line therapy accounted for by dipeptidyl peptidase-4 (DPP-4) inhibitors decreased from 21.9% of treatment visits in 2015 to 20.8% of treatment visits in 2019; sulphonylurea use declined from 45.2% to 32.7%, use of SGLT2 inhibitors increased from 14.5% to 21.2% and use of GLP-1 receptor agonists increased from 9.8% to 18.2%. Significant changes in the landscape of ambulatory care for diabetes have taken place during the past 6 years, including moderate declines in metformin monotherapy, moderate declines in second-line sulphonylurea use, and large increases in SGLT2 use. These changes underscore the dynamic nature of drug utilization for diabetes in the United States, and reflect the effects of emerging evidence, evolving clinical guidelines and evolving regulatory and payment policies.
Substances chimiques
Dipeptidyl-Peptidase IV Inhibitors
0
Hypoglycemic Agents
0
Sodium-Glucose Transporter 2 Inhibitors
0
Metformin
9100L32L2N
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1843-1850Informations de copyright
© 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
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