Diabetes Research and Clinical Practice, Год журнала: 2023, Номер 202, С. 110777 - 110777
Опубликована: Июнь 15, 2023
Язык: Английский
Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(7), С. 2684 - 2694
Опубликована: Апрель 1, 2024
Abstract Aim To evaluate the utilization and prescribing patterns of antidiabetic drugs (ADDs) for patients with type 2 diabetes mellitus (T2DM) at treatment initiation first intensification. Methods A retrospective cohort study was performed using linked routinely collected data T2DM who received ADDs between January 2010 December 2020 in Scotland. The were quantified frequency/percentages, absolute/relative change, trend tests. Results Overall, 145 909 new ADD users identified, approximately 91% ( N = 132 382) receiving a single initiation. Metformin most often prescribed monotherapy 118 737, 89.69%). total 50 731 (39.40%) started on metformin 46 730/118 39.36%) or sulphonylurea (SU; 4001/10 029, 39.89%) had their intensified one more additional ADD. Most initial‐metformin (45 963/46 730; 98.36%) initial‐SU (3894/4001; 97.33%) added further ADDs. SUs (22 197/45 963; 48.29%) common first‐intensifying after initial use, but these replaced by sodium‐glucose cotransporter‐2 (SGLT2) inhibitors 2019 (SGLT2 inhibitors: 2039/6065, 33.62% vs. SUs: 1924/6065, 31.72%). frequently to SU use (2924/3894, 75.09%). Although majority ADD, combination therapy significantly increased over time. Nevertheless, there significant increasing towards newer classes inhibitors, dipeptidyl peptidase‐4 inhibitors) as compared older ones (SUs, insulin, thiazolidinediones) both drug Conclusions An overall observed. However, remained commonly first‐line while SGLT2 add‐on 2019.
Язык: Английский
Процитировано
1
Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(7), С. 2787 - 2795
Опубликована: Апрель 15, 2024
Abstract Aim Sodium‐glucose cotransporter 2 inhibitors (SGLT2is) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) improve glycaemic control cardio‐renal outcomes for people with type diabetes (T2D). However, geographic socio‐economic variation in use is not well understood. Methods We identified 367 829 New South Wales residents aged ≥40 years who dispensed metformin 2020 as a proxy T2D. estimated the prevalence of other glucose‐lowering medicines among T2D SGLT2i GLP‐1RA using concomitant therapy (i.e. + another medicine). measured by small‐level geography, stratified age group, characterized remoteness status. Results The (29.7%) (8.3%) 40‐64 increased areas greater disadvantage, similar to medicines. (55.4%) (15.4%) varied across areas, lower more disadvantaged localized high (2.5 times median). Compared years, was older groups, but patterns areas. Conclusions probably reflecting combination system‐ prescriber‐level factors. Socio‐economic overshadowed prescribing. Continued monitoring can help shape interventions optimize would benefit most.
Язык: Английский
Процитировано
1
International Journal For Multidisciplinary Research, Год журнала: 2024, Номер 6(1)
Опубликована: Янв. 6, 2024
This review navigates the evolving landscape of Type 2 Diabetes (T2D) management by examining recent advancements in medication therapy, spanning from conventional approaches to groundbreaking innovations. Recognizing dynamic nature diabetes treatment, we delve into traditional antidiabetic agents, such as metformin and sulfonylureas, evaluate their sustained relevance context contemporary therapeutic regimens. The synthesis established treatments with novel pharmacological interventions takes center stage explore transformative impact glucagon-like peptide-1 receptor agonists (GLP-1 RAs) sodium-glucose co-transporter-2 inhibitors (SGLT-2Is). These agents not only address glycemic control but also demonstrate cardiovascular renal benefits, reshaping paradigm T2D management. Additionally, investigate promising emerging therapies, including dual triple combination personalized medicine approaches, potential role oral hypoglycemic drugs optimizing treatment strategies. By embracing a fluid integrative perspective, this aims provide healthcare professionals researchers comprehensive understanding diverse pharmacotherapeutic options available, fostering informed decision-making paving way for enhanced care
Язык: Английский
Процитировано
0
Academic Emergency Medicine, Год журнала: 2024, Номер 31(8), С. 832 - 834
Опубликована: Апрель 25, 2024
Metformin has historically been the first-line drug option for Type 2 diabetes mellitus, likely based on UK Prospective Diabetes Study (UKPDS-34 trial), which showed benefits in mortality and myocardial infarction with metformin compared to diet control overweight patients.1 The finding, however, was muddied by a UKPDS substudy showing increased when added sulfonylurea. Neither finding explained or replicated.1 To better assess diabetes, we examined evidence from systematic reviews randomized controlled trials (RCTs) determine harms of management standard care placebo. primary source this evidence-based summary is 2012 meta-analysis 13 studies Boussageon et al.2 including 13,110 patients mellitus. participants had mean age 57 years, 47% were female, body mass index 30, average hemoglobin A1c 8.2%. Comparisons included versus alone placebo, sulfonylurea plus alone, withdrawal continuation. authors found no significant reduction any efficacy outcome (death, cardiovascular death, infarction, stroke, peripheral vascular events, amputation), increase severe hypoglycemic episodes. Adverse events not reported. Separately, single trial comparing rosiglitazone glyburide 16% absolute gastrointestinal adverse (number needed harm [NNH] 6).3 A network published 2023 Shi al.4 also did reduce death outcomes but report contributed finding. would provide information contacted; therefore, could confirm replicate their results. Cochrane review 2020 find qualifying placebo reporting major clinical outcomes.5 Three other excluded because they either observational studies6, 7 (without separate RCTs) that answer question interest8 (i.e., without [e.g., prediabetes] pooled together placebo- active-controlled trials). These findings contrast those UKPDS-34, demonstrated reductions alone.1 While UKPDS-34 low risk bias, there uncertainty results, wide CIs (relative [RR] 0.6, 95% CI 0.5–0.9, difference 7% over 11 number treat [NNT] 14) (RR 0.4–0.9, 6% NNT 16). In trial, 2.0, 1.0–2.5, NNH 17), infarctions.1 Regarding safety, hypoglycemia alone. seems be imprecision: are too rule out clinically important harms. For instance, al. RR 0.8–1.3.2 quality evidence, rated all as 3 4 5 Jadad score (indicating high bias at least one domain).9 three notable shortcomings. made questionable decision pool adding drugs. lacked transparency. unable data considered reliable enough outcomes. This reflected some guidelines. American Association recommends sodium-glucose cotransporter-2 (SGLT2) glucagon-like peptide (GLP)-1 drugs improving heart kidney high-risk patients10 while described providing "potential benefit." Similar recommendations Clinical Endocrinology,11 SGLT2 GLP-1 ahead metformin.12, However, continues most prescribed medication practice.14, 15 Finally, it note may have unclear benefits, few alternatives better. Within al., nine outcomes.4 Furthermore, sulfonylureas insulin cause weight gain16 hypoglycemia,4 thiazolidinediones4 dipeptidyl peptidase-4 inhibitors17-19 failure. only ones shown meta-analyses (SGLT2s4 genital infections ketoacidosis GLP-1s4, events). summary, effects statistically significant, broad cannot potentially meaningful We therefore chosen yellow color recommendation reflect metformin's effects. High-quality RCTs if common practice benefiting people metformin. declare conflicts interest.
Язык: Английский
Процитировано
0
Diabetes Research and Clinical Practice, Год журнала: 2024, Номер 214, С. 111770 - 111770
Опубликована: Июль 4, 2024
Язык: Английский
Процитировано
0
PLoS ONE, Год журнала: 2024, Номер 19(8), С. e0307451 - e0307451
Опубликована: Авг. 15, 2024
Several new classes of medications for diabetes have recently become available newer medication been increasing in use. It is unclear how their utilization varied across provinces and the COVID-19 pandemic may affected these trends. Our objective was to investigate Canada-wide province-specific trends dispensed by drug class over time, while also examining impact related restrictions on dispensing. We conducted a repeated cross-sectional analysis study. Data were obtained from IQVIA’s CompuScript database prescription dispensing patterns primary care January 2018 December 2021. Drug interest biguanides dipeptidyl peptidase 4 inhibitors, sulfonylurea’s, insulins, sodium-glucose co-transporter 2 glucagon-like peptide-1 receptor agonists. examined before after onset with special attention changes during periods high activity. Most displayed stable number prescriptions each month throughout, except agonists which demonstrated consistent pattern increased Sodium-glucose inhibitors exhibited greatest growth period, 7.9% 5.0% increases, respectively. For Prince Edward Island (4.0%) Ontario showed least (2.5%). analogs, Saskatchewan (11.3%) Newfoundland (4.5%). The did not overall However, spikes cases corresponded most classes. Important variations Canada guideline-recommended seems be time. This likely due differing formulary listing access coverages. If so, future research could explore national harmonization health outcomes patients diabetes.
Язык: Английский
Процитировано
0
Diabetes Research and Clinical Practice, Год журнала: 2023, Номер 202, С. 110777 - 110777
Опубликована: Июнь 15, 2023
Язык: Английский
Процитировано
1