scholarly journals Trends of use of SGLT2 inhibitors in Qatar

2021 ◽  
Author(s):  
Nancy Zaghloul ◽  
Ahmed Awaisu ◽  
Ahmed Mahfouz ◽  
Sumaya Al Saadi ◽  
Hazem Elewa
Keyword(s):  
Cross Sectional Study ◽  
Slight Reduction ◽  
Mena Region ◽  
Cross Sectional ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Glucosidase Inhibitors ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Progression Of Renal Disease

Background: Type 2 diabetes mellitus (T2DM) represents a growing health challenge in Qatar and worldwide. T2DM is associated with a high risk of cardiovascular (CV) morbidity and mortality, and progression of renal disease. Sodium glucose co-transporter 2 inhibitors (SGLT2is) are the most recently approved class of glucose lowering medications (GLMs). To date, there is a limited knowledge about the adoption of SGLT2is by clinicians compared to other oral GLMs in Qatar and Middle East and North Africa (MENA) region. Accordingly, this proposed study aims to explore the trends in SGLT2is use compared to other oral GLMs in Qatar from 2016 to 2020. Methods: This is a descriptive, retrospective cross-sectional study where information on all oral GLMs prescriptions dispensed as in- or out-patient from 2016 to 2020 in all Hamad Medical Corporation (HMC) hospitals were collected. Outcomes included the number and relative frequency of quarterly prescriptions of different oral GLMs classes [metformin, sulfonylureas (SUs), dipeptidyl peptidase 4 inhibitors (DPP-4is), thiazolidinediones (TZDs), meglitinides (MEGs), α-glucosidase inhibitors (AGIs), and SGLT2is] from 2016 to 2020. Results: Overall, the prescription rate of GLMs increased during the last five years. SGLT2is use increased over the years after being introduced to the formulary in 2017, replacing SUs which exhibited significant decline between 2017 and 2020. There was a slight reduction in metformin use, and a slight increase in DPP-4is use. TZDs, MEGs, and AGIs prescriptions remained stable. Among SGLT2is, empagliflozin showed considerable increase on the expense of dapagliflozin which decreased significantly by the end of 2018. Conclusion: SGLT2is have been gradually replacing SUs in Qatar and the trend of their use is similar to that reported in other countries. The trend among SGLT2is suggests greater preference for empagliflozin over dapagliflozin.

scholarly journals Trends in diabetes medications in Canada, England, Scotland and Australia: a repeated cross-sectional analysis (2012-2017)

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Sumeet Kalia
Keyword(s):  
Medical Data ◽  
New Drugs ◽  
Cross Sectional ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Sectional Analysis ◽  
Dispensing Data

BackgroundWe studied the uptake of new classes of glucose lowering medications, such as Dipeptidyl peptidase-4 inhibitors (DPP4s) and Sodium-glucose cotransporter 2 inhibitors (SGLT2s) amongst patients living with type 2 diabetes. We compared this in Australia, Canada, England and Scotland, and explored whether these new drugs are supplementing or replacing older classes of medications. Research Design and MethodsWe used primary care Electronic Medical Data on prescriptions (Canada, UK) and dispensing data (Australia) from 2012 to 2017. We included persons aged 40 years or over on at least one glucose lowering medication in each year of interest; we excluded those on insulin only. We determined proportions of patients in each nation on each class of medication, as well as on combinations of classes. ResultsIn 2017, data from 28,063 patients in Canada, 106,000 in Australia, 88,953 in England and 15,603 in Scotland were included. The proportion of patients on metformin increased by 3.4% in Australia (95% CI: 3.24% to 3.55%) and decreased in the other nations. Canada had the greatest decrease, at 4.7% (95% CI: -5.05% to -4.34%). Sulfonylurea use decreased in most nations, while DPP4s increased in all. By 2017, between 10.1% and 15.3% of patients were on a SGLT2 and the use of either a DPP4 or SGLT2 combined with metformin approached or exceeded the use of sulfonylureas with metformin. ConclusionsNewer, more expensive medications are replacing sulfonylureas and, to a lesser degree, metformin. The effects of these trends on health outcomes and overall costs should be examined.

scholarly journals Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
N. Grandfils ◽  
B. Detournay ◽  
C. Attali ◽  
D. Joly ◽  
D. Simon ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cross Sectional Study ◽  
Therapeutic Strategies ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Glucose Lowering ◽  
Patient Profile

Aim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD).Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of French GPs who contribute to the IMS Lifelink Disease Analyzer database. Eligible patients were those with T2DM and moderate-to-severe CKD who visited their GPs at least once during the study period. Data were collected through electronic medical records and an additional questionnaire.Results. 116 GPs included 297 patients: 86 with stage 3a (Group 1, GFR = 45–60 mL/min/1.73 m2) and 211 with stages 3b, 4, or 5 (Group 2, GFR < 45 mL/min/1.73 m2). Patients’ mean age was approximately 75 years. Insulin was used in 19% of patients, and was predominant in those with severe CKD. More than two-thirds of patients were treated with glucose lowering agents which were either contraindicated or not recommended for CKD. Conclusion Physicians most commonly considered the severity of diabetes and not CKD in their therapeutic decision making, exposing patients to potential iatrogenic risks. The recent patient oriented approach and individualization of glycemic objectives according to patient profile rather than standard HbA1c would improve this situation.

scholarly journals Trends in diabetes medication use in Canada, England, Scotland and Australia: a repeated cross-sectional analysis (2012-2017)

2020 ◽  
pp. bjgp20X714089
Author(s):  
Michelle Greiver ◽  
Alys Havard ◽  
Juliana Bowles ◽  
Sumeet Kalia ◽  
Chen Tao ◽  
...  
Keyword(s):  
New Drugs ◽  
Cross Sectional ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Cross Sectional Analysis ◽  
Drug Classes ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Lowering Drug ◽  
Sectional Analysis

Abstract Background: Several new classes of glucose lowering medications have been introduced in the past two decades. Some, such as Sodium-glucose cotransporter 2 inhibitors (SGLT2s), have evidence of improved cardiovascular outcomes, while others, such as Dipeptidyl peptidase-4 inhibitors (DPP4s), do not. It is therefore important to identify their uptake, in order to find ways to support the use of more effective medications. Aims: We studied the uptake of these new classes amongst patients with type 2 diabetes. Design and setting: Retrospective repeated cross-sectional analysis. We compared rates of medication uptake in Australia, Canada, England and Scotland. Method: We used primary care Electronic Medical Data on prescriptions (Canada, UK) and dispensing data (Australia) from 2012 to 2017. We included persons aged 40 years or over on at least one glucose-lowering drug class in each year of interest, excluding those on insulin only. We determined proportions of patients in each nation, for each year, on each class of medication, and on combinations of classes. Results: By 2017, data from 238,609 patients were included. The proportion of patients on sulfonylureas (SUs) decreased in three out of four nations, while metformin decreased in Canada. Use of combinations of metformin and new drug classes increased in all nations, replacing combinations involving SUs. In 2017 more patients were on DPP4s (between 19.1% and 27.6%) than on SGLT2s (between 10.1% and 15.3%). Conclusions: New drugs are displacing SUs. However, despite evidence of better outcomes, the adoption of SGLT2s lagged behind DPP4s.

Sulfonylureas in today’s blood glucose lowering therapy.New data on advantages and potential barriers of an “old” antidiabetic group

2015 ◽  
Vol 156 (13) ◽  
pp. 511-515
Author(s):  
Gábor Winkler
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Sulfonylurea Compounds ◽  
Drug Of Choice ◽  
Antidiabetic Treatment ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucose Lowering Therapy

Sulfonylurea compounds have been basic elements of antidiabetic treatment in type 2 diabetes for a long time. However, with the introduction of incretin type insulin secretagogues it is often arises, whether is still there a place for sulfonylureas in the today’s therapy. To answer this question the author overviews general pharmaceutical characteristics of the sulfonylurea compounds as well as individual particularities of the second generation derivatives used at present in Hungary. The author details also the most important differences between incretin type drugs − first of all dipeptidyl peptidase-4 inhibitors − and sulfonylureas. On the basis of available data it can be concluded in accordance with the latest international guidelines, that sulfonylureas have still role in the blood glucose lowering therapy of type 2 diabetes, though they became somewhat pushed back among insulin secretagogue type drugs. If a sulfonylurea compound is the drug of choice, it is important to select the appropriate molecule (in case of normal renal function gliclazide or glimepiride). It is also important to re-educate the patient, as well as to apply the minimal dose providing the desired glycaemic effect. Orv. Hetil., 2015, 156(13), 511–515.

scholarly journals Lifestyle Factors Associated with Type 2 Diabetes and Use of Different Glucose-Lowering Drugs: Cross-Sectional Study

PLoS ONE ◽  
2014 ◽  
Vol 9 (11) ◽  
pp. e111849 ◽  
Author(s):  
Sinna P. Ulrichsen ◽  
Anil Mor ◽  
Elisabeth Svensson ◽  
Finn B. Larsen ◽  
Reimar W. Thomsen
Keyword(s):  
Type 2 Diabetes ◽  
Cross Sectional Study ◽  
Lifestyle Factors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Glucose Lowering ◽  
Factors Associated

scholarly journals Trust and VERIFY: the role of combined treatment with metformin and dipeptidyl peptidase-4 inhibitors in new-onset diabetes type 2

2020 ◽  
Vol 4 (6) ◽  
pp. 334-339
Author(s):  
T.Yu. Demidova ◽  
◽  
A.A. Kozhevnikov ◽  
Keyword(s):  
Combined Treatment ◽  
Diabetes Type 2 ◽  
Dipeptidyl Peptidase ◽  
Diabetes Type ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucose Lowering Therapy

Diabetes is a progressive disease that manifests itself in hyperglycemia and is associated with macro- and microvascular complications. Stepwise approach to glucose-lowering therapy is now often questioned for two main reasons. First, the decision on intensifying the treatment requires the decompensation of carbohydrate metabolism. Second, this conception does not always meet the criteria of pathophysiological treatment, in particular, in patients who are newly diagnosed with diabetes type 2 and recommended with metformin monotherapy. The combination of metformin and dipeptidyl peptidase-4 (DPP-4) inhibitors is a well-known strategy that effectively controls blood glucose level and preserves beta cell functions. VERIFY study has demonstrated that after a 5-year follow-up, median time to type 2 diabetes decompensation is 36.1 months in metformin group and 61.9 months in early combined treatment group (metformin plus vildagliptin) (p<0.0001). These findings can account for paradigm shift in treatment prescription for newly diagnosed type 2 diabetes in patients with HbA1c less than 1,0% of the target level.KEYWORDS: diabetes, glucose-lowering therapy, control of glycemia, combined treatment.FOR CITATION: Demidova T.Yu., Kozhevnikov A.A. Trust and VERIFY: the role of combined treatment with metformin and dipeptidyl peptidase-4 inhibitors in new-onset diabetes type 2. Russian Medical Inquiry. 2020;4(6):334–339. DOI: 10.32364/2587-6821-2020-4-6-334-339.

scholarly journals Impact of Glucose-Lowering Medications on Cardiometabolic Risk in Type 2 Diabetes

2019 ◽  
Author(s):  
Angelo Maria Patti ◽  
Ali A Rizvi ◽  
Rosaria Vincenza Giglio ◽  
Anca Pantea Stoian ◽  
Daniela Ligi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Subclinical Atherosclerosis ◽  
Macrophage Polarization ◽  
Vascular Complications ◽  
Rapid Progression ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Antidiabetic Treatment ◽  
Dipeptidyl Peptidase 4 Inhibitors

Type 2 Diabetes Mellitus (T2DM) is associated with a high risk of atherosclerotic cardiovascular (CV) disease. Contributing pathophysiologic factors include endothelial dysfunction caused by excessive production of reactive oxygen species (ROS), increased activity of nuclear factor kB (NFkB), altered macrophage polarization, and reduced synthesis of endothelial progenitor cells (EPC). Consequently, there can be a potentially rapid progression of the atherosclerotic disease with a higher propensity to unstable plaque, leading to increased cardiovascular mortality. Management is aimed at prevention, early diagnosis, and treatment of hyperglycemia and vascular complications. Innovative therapeutic approaches for T2DM seek to customize the antidiabetic treatment to each patient in order to optimize glucose-lowering effects, minimize hypoglycemia and adverse effects, and prevent cardiovascular events. The newer drugs (Glucagon Like Peptide-1 Receptor Agonists, GLP-1 RAs; Sodium GLucose coTransporter-2 inhibitors, SGLT2is; DiPeptidyl Peptidase-4 inhibitors, DPP4is) impact body weight, lipid parameters, and blood pressure, as well as endothelial function, inflammatory markers, markers of oxidative stress, and subclinical atherosclerosis. The present review summarizes the results of trials that evaluated the cardiovascular safety of these drugs and found them to be safe from the CV standpoint.

scholarly journals Initial Therapeutic Choices for Type 2 Diabetes in the Portuguese Sentinel Practice Network

2019 ◽  
Vol 32 (5) ◽  
pp. 375
Author(s):  
Daniel Pinto ◽  
Ana Paula Rodrigues ◽  
Baltazar Nunes
Keyword(s):  
Type 2 Diabetes ◽  
Family Physicians ◽  
Initial Therapy ◽  
Prescribing Patterns ◽  
Cross Sectional ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Incident Cases ◽  
Practice Network

Introduction: Type 2 diabetes is a major driver of pharmaceutical spending. We aimed to determine the proportion of new patients who begin treatment with each antidiabetic medicine class, if therapy was initiated by their family physician, if family physicians alter prescriptions initiated by other physicians, and to compare prescribing patterns of family physicians and other specialists.Material and Methods: Cohort-nested cross-sectional study within the Portuguese Sentinel Practice Network. Between 2014 and 2015, incident cases of type 2 diabetes were notified, thus reporting treatment, who made the initial prescription and if treatments initiated by other physicians were changed.Results: A total of 415 incident cases were notified. The initial prescription was made by Sentinel Practice Network physicians in 89.4% of cases (95% CI 86.0% - 92.0%). Metformin was most often chosen as the first treatment, prescribed to 85.5% of patients (95% CI 81.8% – 88.6%). Family physicians used less dipeptidyl peptidase-4 inhibitors (4.2% vs 30.3%, p < 0.001) and insulin (0.3% vs 12.1%, p < 0.001) compared to other specialists. Prescriptions initiated by others were changed in 4.5% of cases (95% CI 0.4% - 16.0%).Discussion: Prospective data collection is a major study strength, but few cases of treatment initiated by non-family physicians were notified. Data for disease severity was unavailable and could partly explain differences between family physicians and other specialists.Conclusion: Metformin was most often chosen as initial therapy, in line with Portuguese guideline recommendations. Sentinel Practice Network physicians diagnosed most cases, seldom changed prescriptions initiated by others, and had a different pattern of antidiabetic medicines use compared to other specialists.

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