How body weight relates to oral diabetes drug prescriptions in Japanese type 2 diabetes patients and how specialists' choices changed from 2002 to 2019
In 2019, about 90% of type 2 diabetes mellitus patients had a BMI < 30 kg/m.
The usage of sulfonylureas decreased from 44.5% in 2002 to 23.2% in 2019.
The use of increased significantly from 19.3% to 50.3% over the same period.
(DPP4is) became the most commonly prescribed oral antidiabetic drugs, reaching 56.9% in 2019.
(SGLT2is) usage rose to 23.6% in 2019.
For patients with a BMI > 30 kg/m, the use of biguanides and SGLT2is increased, while sulfonylureas and DPP4is decreased.
Simplified
AIMS/INTRODUCTION: Type 2 diabetes mellitus is caused by a relative imbalance between insulin secretion and sensitivity related to the body mass index (BMI). Seven categories of oral antidiabetic drugs (OADs) are available in Japan. It is important to assess the OAD utilization patterns based on patients' BMI levels.
MATERIALS AND METHODS: OAD prescribing patterns from 2002 to 2019 were analyzed using the data collected in the computerized diabetes care database provided by the Japan Diabetes Clinical Data Management Study Group; OAD utilization patterns in 25,751 OAD-treated type 2 diabetes mellitus patients registered in 2019 were analyzed after classifying them into five categories of BMI.
RESULTS: Comparing OAD usage between 2002 and 2019, sulfonylureas decreased from 44.5 to 23.2%, and (BGs) increased from 19.3 to 50.3%. (DPP4is) increased to 56.9% in 2019. (SGLT2is) increased to 23.6% in 2019. About 90% of type 2 diabetes mellitus patients had BMI < 30 kg/m. DPP4is were the most used OADs in 2019. When BMI exceeded 30 kg/m, use of BGs and sodium-glucose cotransporter 2 inhibitors increased, and use of sulfonylureas and DPP4is decreased. Although DPP4is were the most used OADs for patients with BMI <30 kg/m, they were the third most prescribed OADs for patients with BMI >35 kg/mafter BGs and sodium-glucose cotransporter 2 inhibitors . 2 2 2 2
CONCLUSIONS: DPP4i usage was as high as that of BG in the analysis of Japanese type 2 diabetes mellitus patients with relatively low BMI. This was considered to be a treatment option appropriate for the pathophysiology in Japanese patients.
Key numbers
56.9%
DPP4i Usage Rate
Percentage of patients using in 2019.
21.3%
Sulfonylurea Usage Decrease
Decrease from 44.5% in 2002 to 23.2% in 2019.
31.0%
Biguanide Usage Increase
Increase from 19.3% in 2002 to 50.3% in 2019.
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SS has received lecture fees from Novo Nordisk Pharma, Eli Lilly Japan and Sanofi K.K. HM has received research support unrelated to this study from Astellas Pharma Inc., Astra Zeneca K.K., Ono Pharmaceutical, Nippon Boehringer Ingelheim, Takeda Pharmaceutical, Daiichi Sankyo, Mitsubishi Tanabe Pharma, and Sano, and lecture fees from Astellas Pharma, Taisho Toyama Pharmaceutical, Ono Pharmaceutical, Novo Nordisk Pharma, Eli Lilly Japan, MSD, Daiichi Sankyo, Nippon Boehringer Ingelheim, Mitsubishi Tanabe Pharma, Sano, Kowa Pharmaceutical and Takeda Pharmaceutical. NY, IK, KA, MO, YF, HY, KY and H.S. declare no conflict of interest.
