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  3. Glucose-lowering medication prescription profile outside W Europe and N America from 2006-2012: evidence from multiple clinical sites

Glucose-lowering medication prescription profile outside W Europe and N America from 2006-2012: evidence from multiple clinical sites (#308)

Stephanie K Tanamas 1 , Silver Bahendeka 2 , Chern-En Chiang 3 , Juan Jose Gagliardino 4 , Sanjay Kalra 5 , Andrea Luk 6 , Hiroshi Maegawa 7 , A Ramachandran 8 , Filip Surmont 9 , Khaled Tayeb 10 , Olga Vikulova 11 , Jonathan E Shaw 1
  1. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  2. San Raphael of St. Francis Nsambya Hospital, Kampala, Uganda
  3. General Clinical Research Center, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
  4. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, Argentina
  5. Bharti Research Institute of Diabetes & Endocrinology, Bharti Hospital, Karnal, Haryana, India
  6. Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong SAR, China
  7. Shiga University of Medical Science, Shiga, Japan
  8. Dr A Ramachandran’s Diabetes Hospitals, Chennai, India
  9. AstraZeneca, Shanghai, China
  10. Diabetes Center at Al‐Noor Specialist Hospital, Makkah, Saudi Arabia
  11. FGBU "Endocrinology Research Center”, Ministry of Health, Russia

Aims

To characterize the use of glucose-lowering medication (GLM) in people with type 2 diabetes in countries outside West Europe and North America between 2006 and 2012.

 

Methods

Data from eleven clinical services (from Argentina, Australia, Hong Kong, India, Japan, Saudi Arabia, Uganda)  and two national registries (Russia, Taiwan) (n of patients per site: range 278 - 1737000) that have used electronic medical records to manage people with diabetes for several years were collected and pooled for statistical analysis. Each site summarized data extracted from out-patient medical records for 2006 and 2012 related to: demographics; disease history; diabetic complications; percentages on various classes of GLM as monotherapy, combined therapy or insulin, blood pressure- and lipid-lowering drugs; and mean laboratory values related to glycaemic and lipid levels as well as renal function.

 

Results

Between 2006 and 2012, the percentage of patients on monotherapy with sulphonylureas decreased in all sites (range -84 to -4%), with a decrease greater than 20% in all but one site, while change in monotherapy with metformin varied between -41 to +206%.  Overall sulphonylurea use did not decrease much over time (range -55 to +31%) with only 3 sites demonstrating a decrease greater than 20%. The percentage of patients on monotherapy or on non-pharmacological therapy fell in all sites (range -15 to -39%) except for one (12% increase). Usage of insulin as monotherapy was >5% in most sites and generally increased or remained stable between 2006 and 2012. Only Australia and India had a prevalence of insulin monotherapy use under 5%. In 2012, the percentage on DPP-IV inhibitors varied widely, ranging from 0.58% in Russia to 23% in Australia.

 

Conclusion

Despite marked differences in healthcare settings, there were several consistent prescription patterns: a) the percentage of people managed with non-pharmacological treatment or on monotherapy decreased; b) whilst use of sulphonylureas as monotherapy decreased, sulphonylureas continued to be frequently used in combination therapy; and c) usage of DPP-IV inhibitors varied widely across sites.

 

Disclosure statement

This study was supported by AstraZeneca.