Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes.

Abstract

AIM:

To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.

METHODS:

We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).

RESULTS:

Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose-lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95% CI: 1.16-1.44) and 3.60 (95% CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95% CI: 1.05-1.38) and 2.08 (95% CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95% CI: 1.04-1.44) and 1.93 (95% CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95% CI: 1.10-1.42) and 1.94 (95% CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5%) [RR: 1.26 (95% CI: 1.20-1.32) and 2.86 (95% CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.

CONCLUSIONS:

Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.

• Authors: A Mor, K Berencsi, E Svensson, J Rungby, J S Nielsen, S Friborg, I Brandslund, J S Christiansen, A Vaag, H Beck-Nielsen, H T Sørensen, R W Thomsen
• Journal: Diabetic medicine : a journal of the British Diabetic Association (Diabet Med) Vol. 32 Issue 12 Pg. 1546-54 (Dec 2015) ISSN: 1464-5491 [Electronic] England
• PMID: 26032247 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Chemical References

• Hypoglycemic Agents
• Metformin

Topics

• Adult
• Age Factors
• Aged
• Body Mass Index
• Cohort Studies
• Denmark
• Diabetes Mellitus, Type 2 (blood, complications, drug therapy)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• General Practitioners
• Hospitalists
• Humans
• Hyperglycemia (prevention & control)
• Hypoglycemic Agents (therapeutic use)
• Male
• Metformin (therapeutic use)
• Middle Aged
• Obesity, Abdominal (complications)
• Outpatient Clinics, Hospital
• Practice Patterns, Physicians'
• Prospective Studies
• Registries