Glucose-lowering drug prescriptions in patients with newly diagnosed type 2 diabetes: statutory health insurance data from 2012 – 2016

Background:

The aim of this study was to describe prescribing patterns of glucose-lowering drugs (GLD) in newly diagnosed type 2 diabetes (T2DM) in Germany.

Methods:

Using the German Pharmacoepidemiological Research Database, based on claims data from four statutory health insurance providers (> 20 million insurants), we identified a cohort of newly diagnosed T2DM patients. Eligible patients had a first diagnosis for T2DM (ICD-10-GM-2019 E11 or E14, exclusively) between January 2012 and December 2016 and had continuous insurance for at least three years prior to diagnosis. Considering all types of GLD (ATC: A10A, A10B) we assessed type and frequency of prescribed first-line treatment strategies.

Results:

We identified 443,599 newly diagnosed T2DM patients (mean age: 63.2 ± 14.3 years; 48% males). About 25% of newly diagnosed diabetes patients received GLD in the first year of diagnosis. Of these, 78.1% were prescribed metformin monotherapy and 7.6% used metformin in combination with one or more drugs from other GLD classes. Insulin monotherapy and insulin combination therapy were prescribed in 5.0% and 5.1%, respectively. The newer incretin-based GLD were prescribed less frequently as monotherapy (3.5% dipeptidyl peptidase-4 inhibitors, 0.2% glucagon-like peptide-1 receptor agonists, and 0.3% sodium-glucose cotransporter 2 inhibitors), however, in 53% of all prescribed combination therapies one of these newer GLD was used.

Conclusion:

About three quarters of newly diagnosed T2DM patients were not treated with any GLD during the first year after their diabetes diagnosis. In agreement with diabetes care guidelines, the newer incretin-based drugs were more often prescribed in combination with other GLD.