Treatment trajectories for Danish individuals with type 2 diabetes in the era of emerging glucose‐lowering therapies

🥉 Top 5% JournalSep 16, 2024Diabetes, obesity & metabolism

Treatment patterns over time for Danish people with type 2 diabetes as new blood sugar medicines become available

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

A total of 260,393 individuals initiated a new glucose-lowering therapy class in Denmark from 2016 to 2023.

Initiators of GLP-1 receptor agonists (GLP-1RAs) increased by 6-fold, while those of sodium-glucose co-transporter-2 inhibitors (SGLT-2is) rose by 3-fold during the study period.
The median HbA1c level at the start of treatment with GLP-1RAs or SGLT-2is decreased from 67-68 mmol/mol in 2016-2017 to 57-58 mmol/mol in 2022-2023.
The proportion of individuals starting additional glucose-lowering therapy within 2 years after initiating metformin increased from 25% in 2016 to 40% in 2021.
Among those with established cardiorenal disease, 22% used SGLT-2is and 18% used GLP-1RAs after 2.5 years, compared to 17% and 21% in those without cardiorenal disease.

AI simplified

AIM: To analyse patterns of glucose-lowering therapies among people with type 2 diabetes (T2D) in Denmark from 2016 to 2023.

MATERIALS AND METHODS: We examined time trends in the clinical profiles of people with T2D who initiated different glucose-lowering therapy classes for the first time. We furthermore investigated individual-level treatment trajectories following first-ever glucose-lowering therapy in people with or without cardiorenal disease. The study utilized data from the nationwide Danish health registries and included all individuals who filled a first-ever prescription for metformin, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), sodium-glucose co-transporter-2 inhibitors (SGLT-2is) or insulin, excluding those without HbA1c-confirmed T2D or probable type 1 diabetes.

RESULTS: We included 260 393 individuals initiating a new glucose-lowering therapy class from 2016 to 2023, during which there were 6- and 3-fold increases in initiators of GLP-1RAs and SGLT-2is, respectively. The median HbA1c level at treatment initiation with GLP-1RAs or SGLT-2is decreased, from 67-68 mmol/mol in 2016-2017 to 57-58 mmol/mol in 2022-2023. Among individuals who initiated metformin as first-line therapy, the proportion who started additional glucose-lowering therapy within 2 years increased from 25% in 2016 to 40% in 2021. Among the 38% of individuals who had established cardiorenal disease when they initiated first-ever glucose-lowering therapy in 2020, 22% used SGLT-2is and 18% GLP-1RAs after 2.5 years, compared with 17% and 21% among initiators without cardiorenal disease, respectively.

CONCLUSIONS: Our study documents a trend towards earlier T2D treatment intensification and an increase in the use of GLP-1RAs and SGLT-2is in Denmark. However, optimal T2D treatment is still not received by most individuals with early T2D and established cardiorenal disease.

Full Text

Full text is available at the source.

View full text ↗

Abstract

Full Text

Related papers