Evolving channeling in prescribing SGLT ‐2 inhibitors as first‐line treatment for type 2 diabetes

2022 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

scholarly journals 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

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>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 antidiabetic 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. </p> <p>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.</p>

First-line treatment for type 2 diabetes: is it too early to abandon metformin?

The Lancet ◽  
2020 ◽  
Vol 396 (10264) ◽  
pp. 1705-1707
Author(s):  
Francesco Zaccardi ◽  
Kamlesh Khunti ◽  
Nikolaus Marx ◽  
Melanie J Davies
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

scholarly journals 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

2021 ◽  
Author(s):  
HoJin Shin ◽  
Sebastian Schneeweiss ◽  
Robert J. Glynn ◽  
Elisabetta Patorno
Keyword(s):  
Type 2 Diabetes ◽  
Line Treatment ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Adult Type ◽  
Antidiabetic Treatment ◽  
Glucagon Like Peptide 1 ◽  
Lowering Drug ◽  
First Line Treatment

<p>Objective: We evaluated recent utilization trends and predictors of first-line antidiabetic treatment in patients with type 2 diabetes.</p> <p>Research Design and Methods: Using two large U.S. health insurance databases (Clinformatics and Medicare), we identified adult type 2 diabetes patients who initiated antidiabetic treatment from 2013 through 2019. Quarterly trends in use of first-line antidiabetic treatment were plotted overall and stratified by cardiovascular disease (CVD). Multinomial logistic regressions were fit to estimate predictors of first-line antidiabetic treatment, using metformin, the recommended first-line treatment for type 2 diabetes, as the common referent.</p> <p>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 antidiabetic 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. </p> <p>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.</p>

scholarly journals Cardiovascular Risk Associated With Acarbose Versus Metformin as the First-Line Treatment in Patients With Type 2 Diabetes: A Nationwide Cohort Study

2015 ◽  
Vol 100 (3) ◽  
pp. 1121-1129 ◽  
Author(s):  
Chia-Hsuin Chang ◽  
Yi-Cheng Chang ◽  
Jou-Wei Lin ◽  
Shu-Ting Chen ◽  
Lee-Ming Chuang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment
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