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Journal article
Trends in Prescribing Preferences for Antidiabetic Medications Among Patients With Type 2 Diabetes in the U.K. With and Without Chronic Kidney Disease, 2006–2020
Diabetes care, v 45(10), pp 2316-2325
01 Oct 2022
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE To evaluate trends in antidiabetic medication initiation patterns among patients with type 2 diabetes mellitus (T2DM) with and without chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS A retrospective cohort study using the UK Clinical Practice Research Datalink (2006–2020) was conducted to evaluate the overall, first-, and second line (after metformin) medication initiation patterns among patients with CKD (n = 38,622) and those without CKD (n = 230,963) who had T2DM. RESULTS Relative to other glucose-lowering therapies, metformin initiations declined overall but remained the first-line treatment of choice for both patients with and those without CKD. Sodium-glucose cotransporter-2 (SGLT2i) use increased modestly among patients with CKD, but this increase was more pronounced among patients without CKD; by 2020, patients without CKD, compared with patients with CKD, were three (28.5% vs. 9.4%) and six (46.3% vs. 7.9%) times more likely to initiate SGLT2i overall and as second-line therapy, respectively. Glucagon-like peptide 1 receptor agonist (GLP-1RA) use was minimal regardless of CKD status (<5%), whereas both dipeptidyl peptidase-4 inhibitor (DPP4i) and sulfonylurea use remained high among patients with CKD. For instance, by 2020, and among patients with CKD, DPP4i and sulfonylureas constituted 28.3% and 20.6% of all initiations, and 57.4% and 30.3% of second-line initiations, respectively. CONCLUSIONS SGLT2i use increased among patients with T2DM, but this increase was largely driven by patients without CKD. Work is needed to identify barriers associated with the uptake of therapies with proven cardiorenal benefits (e.g., SGLT2i, GLP-1RA) among patients with CKD.
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Details
- Title
- Trends in Prescribing Preferences for Antidiabetic Medications Among Patients With Type 2 Diabetes in the U.K. With and Without Chronic Kidney Disease, 2006–2020
- Creators
- Julia Liaw - Rutgers, The State University of New JerseyMeera Harhay - Drexel UniversitySoko Setoguchi - Rutgers, The State University of New JerseyTobias Gerhard - Rutgers, The State University of New JerseyChintan Dave - Rutgers, The State University of New Jersey
- Publication Details
- Diabetes care, v 45(10), pp 2316-2325
- Publisher
- American Diabetes Association
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000905196800028
- Scopus ID
- 2-s2.0-85139375147
- Other Identifier
- 991019335485604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Endocrinology & Metabolism