1107-P: Trends of First-Line Antidiabetic Treatment among 2007-2017 Medicare Beneficiaries Newly Diagnosed with Type 2 Diabetes (T2D) and Their Determinants

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 1107-P
Author(s):  
YUJIA LI ◽  
INMACULADA HERNANDEZ ◽  
NICO GABRIEL ◽  
SANDRA L. KANE-GILL ◽  
UTIBE ESSIEN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Newly Diagnosed ◽  
Medicare Beneficiaries ◽  
First Line ◽  
Antidiabetic 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 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>

Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

2021 ◽  
Author(s):  
Brenda Bongaerts ◽  
Bianca Kollhorst ◽  
Oliver Kuss ◽  
Iris Pigeot ◽  
Wolfgang Rathmann
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Diagnosis ◽  
Research Database ◽  
Second Line ◽  
Newly Diagnosed ◽  
First Line ◽  
Glucose Lowering ◽  
Receptor Agonists ◽  
Metformin Monotherapy

Abstract Aims To describe dispensation patterns of glucose-lowering drugs in newly diagnosed type 2 diabetes in Germany. Materials and methods Based on claims data from four statutory health insurances (German Pharmacoepidemiological Research Database,>25 million insurants), all individuals with newly diagnosed type 2 diabetes were identified. Eligible patients had a first diagnosis for type 2 diabetes between January 2012 and December 2016. We analyzed the dispensation patterns of first-line glucose-lowering therapies initiated in the year after diabetes diagnosis and patterns of second-line therapies dispensed one year after first-line treatment. Results A total of 356,647 individuals with newly diagnosed type 2 diabetes were included (average age [SD]: 63.5 [13.4] years; 49.3% males). Of the 31.6% of individuals who were pharmacologically treated in the year after diagnosis, metformin monotherapy was most frequently dispensed (73.1%), followed by dual therapy of metformin and dipeptidyl peptidase-4 inhibitors (DPP-4is) (6.4%), and monotherapy with DPP-4is (2.9%). From 2012 through 2016, sulfonylurea dispensations were reduced by more than 50%. Dispensations for combination therapies with DPP-4is increased up to 10.6%. Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors contributed to 2% of all treatments. After a median of 5 months, 20.0% of individuals on pharmacological therapy initiated second-line glucose-lowering treatment. Conclusions Data from German statutory health insurances (2012 to 2016) showed that most individuals with newly diagnosed type 2 diabetes were dispensed metformin monotherapy in line with diabetes care guidelines. A substantial decrease in the use of sulfonylureas was observed after the introduction of DPP-4i and GLP-1 receptor agonists.

scholarly journals Circulating Nesfatin-1 Levels and Type 2 Diabetes: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ting Zhai ◽  
Shi-Zhen Li ◽  
Xin-Tong Fan ◽  
Zhao Tian ◽  
Xiao-Qing Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Control Group ◽  
Newly Diagnosed ◽  
Antidiabetic Treatment ◽  
The Relationship ◽  
Diabetes Patients

The role of nesfatin-1 in glucose homeostasis has been investigated previously. However, although numerous studies have examined the relationships between circulating nesfatin-1 levels and type 2 diabetes, the conclusions are contradictory. We aimed to probe the relationship between circulating nesfatin-1 levels and type 2 diabetes by meta-analysis. Seven studies including 328 type 2 diabetes patients and 294 control subjects were included. Although there was no obvious difference in circulating nesfatin-1 levels between patients with type 2 diabetes and the control group (MD = −0.04; 95% CI = −0.32 to −0.23), subgroup analysis showed higher nesfatin-1 levels in newly diagnosed type 2 diabetes patients (MD = 0.59; 95% CI = 0.45 to 0.74) and significantly lower nesfatin-1 levels in type 2 diabetes patients receiving antidiabetic treatment (MD = −0.26; 95% CI = −0.33 to −0.20). In conclusion, the analysis supports a relationship between circulating nesfatin-1 levels and type 2 diabetes, where newly diagnosed type 2 diabetes was associated with an elevated Nesfatin-1 level, and type 2 diabetes patients receiving antidiabetic treatment showed lower circulating nesfatin-1 levels.

Antidiabetic Treatment, Level of Glycemic Control, and Risk of Fracture in Type 2 Diabetes: a Nested, Case-Control Study

2020 ◽  
Author(s):  
Sarah Charlier ◽  
Janina Vavanikunnel ◽  
Claudia Becker ◽  
Susan S Jick ◽  
Christian Meier ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Case Control ◽  
Control Analysis ◽  
Newly Diagnosed ◽  
Antidiabetic Medication ◽  
Risk Of Fracture ◽  
Antidiabetic Treatment ◽  
Nested Case Control

Abstract Context Patients with type 2 diabetes mellitus (T2DM) have an increased risk of low-trauma fractures. However, the effect of antidiabetic medication in relation to glycemic control on the risk of fracture is poorly understood. Objective This work aimed to evaluate the association between the level of glycemic control, use of antidiabetic medication, and risk of low-trauma fractures in patients with newly diagnosed T2DM. Methods We conducted a nested case-control analysis among individuals registered in the Clinical Practice Research Datalink. The base population consisted of patients with newly diagnosed T2DM from 1995 to 2017. Cases were patients with a low-trauma fracture after T2DM diagnosis. We matched 4 controls to each case. Exposures of interest were glycemic control (last glycated hemoglobin [HbA1c] level before fracture) and type of diabetes treatment. We conducted conditional logistic regression analyses adjusted for several confounders. Results We identified 8809 cases and 35 219 controls. Patients with current metformin use and HbA1c levels of less than 7.0% and between 7.0-8.0% had a reduced risk of fractures (adjusted odds ratio 0.89; 95% CI, 0.83-0.96 and 0.81; 95% CI, 0.73-0.90, respectively) compared with untreated patients. However, in patients receiving metformin plus 1 or 2 other antidiabetic drugs, or insulin (alone or in addition to other antidiabetic medication), the level of glycemic control was not associated with the risk of fracture compared with untreated patients. Conclusions While patients with good or medium glycemic control receiving current metformin monotherapy had a lower risk of fracture compared with untreated patients, glycemic control in patients receiving treatment other than metformin was not associated with risk of fracture.

Economic Model of First-Line Drug Strategies to Achieve Recommended Glycaemic Control in Newly Diagnosed Type 2 Diabetes Mellitus

2003 ◽  
Vol 21 (11) ◽  
pp. 819-837 ◽  
Author(s):  
Joe W Ramsdell ◽  
Seth N Braunstein ◽  
Jennifer M Stephens ◽  
Christopher F Bell ◽  
Marc F Botteman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Economic Model ◽  
Newly Diagnosed ◽  
First Line ◽  
Line Drug

scholarly journals The synergistic action of antioxidative enzymes - correlations of catalase and superoxide dismutase in the development and during the treatment of type 2 diabetes

2019 ◽  
Vol 147 (5-6) ◽  
pp. 286-294
Author(s):  
Radoslav Pejin ◽  
Djordje Popovic ◽  
Ilija Tanackov ◽  
Artur Bjelica ◽  
Dragana Tomic-Naglic ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Superoxide Dismutase ◽  
Antioxidative Enzymes ◽  
Dynamic Balance ◽  
Normal Glucose Tolerance ◽  
Normal Weight ◽  
Control Group ◽  
Newly Diagnosed ◽  
Antidiabetic Treatment

Introduction/Objective. The wider literature review of analysis in levels of catalase (CAT) or superoxide dismutase (SOD) enzymes in type 2 diabetes mellitus (T2DM) patients shows no pronounced consistency. We have assumed that the onset of diabetes does not significantly change individual quantities of these enzymes, but instead it changes the relationship of these enzymes. Methods. The study consisted of four groups (n = 30 for each group): obese individuals with disturbed glucose metabolism (subjects with newly diagnosed T2DM) before and after metformin treatment initiation, obese subjects with normal glucose tolerance (NGT) and a control group of healthy normal weight subjects. Appropriate anthropometric measurements and laboratory tests of biochemical parameters and antioxidative enzymes were carried out in all participants. Results. Our study has confirmed that correlation of enzymes CAT and SOD is significantly changed in patients with newly diagnosed T2DM, and that it can be restored by reestablishment of glucose homeostasis with adequate antidiabetic treatment. Conclusion. The applied therapy restores the dynamic balance of CAT and SOD, mainly through the reintegration of the new equilibrium in the enzyme system after achieving better glycemic control. These conclusions are only valid in the initial stages of T2DM treatment.

Metabolic flexibility, insulin sensitivity and genetic variations in newly diagnosed patients with type 2 diabetes

2015 ◽  
Vol 10 (S 01) ◽  
Author(s):  
M Apostolopoulou ◽  
K Strassburger ◽  
B Knebel ◽  
J Kotzka ◽  
J Szendroedi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Sensitivity ◽  
Genetic Variations ◽  
Metabolic Flexibility ◽  
Newly Diagnosed

Lipid profile of patients newly diagnosed with type 2 diabetes in Albania

2013 ◽  
Author(s):  
Florian Toti ◽  
Aldi Shehu ◽  
Kliti Hoti ◽  
Manjola Carcani ◽  
Adriana Lapardhaja ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Newly Diagnosed
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