Sulfonylurea prescription patterns in elderly patients with type 2 diabetes mellitus: A comprehensive analysis of real-world data from pharmacies in Japan

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Investigation Pub Date : 2024-09-03 DOI:10.1111/jdi.14302

Michiko Yamazaki, Tohru Takebe, Masaya Hosokawa, Tomoya Saika, Yutaka Nakao, Shunya Ikeda, Masaya Sakamoto

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Abstract

Aims/Introduction

The study aim was to investigate sulfonylurea prescription patterns in elderly patients (age ≥65 years) with type 2 diabetes mellitus in Japan. Sulfonylurea use among older adults has been insufficiently examined, despite the associated risks of hypoglycemia.

Materials and Methods

This retrospective cross-sectional survey entailed analysis of Japanese pharmacy data, extracted from the Musubi database, for patients (age 20–100 years) prescribed sulfonylureas between November 2022 and October 2023. Dose distribution, adherence to the Diabetes Treatment Guidelines for the Elderly 2023 and coprescription of other diabetes medications were investigated.

Results

Of the total 91,229 patients, 80.1% were prescribed glimepiride, 16.3% gliclazide and 3.6% glibenclamide. In patients aged ≥65 years, exceeding the recommended dose (>1 mg/day for glimepiride, >40 mg/day for gliclazide) was numerically higher for glimepiride (25.0%) than for gliclazide (7.8%). The most common prescribing patterns were quadruple therapy with a sulfonylurea, a dipeptidyl peptidase-4 inhibitor, an sodium–glucose transporter 2 inhibitor and a biguanide in patients aged 65 to <75 years, and dual therapy with a sulfonylurea and a dipeptidyl peptidase-4 inhibitor in patients aged ≥75 years. Unfortunately, glinide was coprescribed for 338 (0.5%) of elderly patients. Insulin was coprescribed for 3,682 (5.6%) of elderly patients.

Conclusions

Analysis of real-world sulfonylurea prescription data found guideline non-adherence, namely, excessive prescription of glimepiride, use of glibenclamide in elderly patients, and common coprescription with dipeptidyl peptidase-4 inhibitors. These findings might provide an opportunity to reconsider the treatment of patients with type 2 diabetes mellitus who are over-prescribed sulfonylureas to reduce residual risks, such as hypoglycemia.

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老年 2 型糖尿病患者的磺酰脲类处方模式：对日本药房真实数据的综合分析。

目的/简介：研究旨在调查日本老年 2 型糖尿病患者（年龄≥65 岁）的磺脲类处方模式。尽管磺脲类药物具有低血糖的相关风险，但对老年人使用磺脲类药物的情况研究不足：这项回顾性横断面调查分析了从 Musubi 数据库中提取的日本药房数据，涉及 2022 年 11 月至 2023 年 10 月期间处方磺脲类药物的患者（年龄在 20-100 岁之间）。调查了剂量分布、《2023 年老年人糖尿病治疗指南》的遵守情况以及其他糖尿病药物的联合处方情况：结果：在 91,229 名患者中，80.1% 处方格列美脲，16.3% 处方格列齐特，3.6% 处方格列本脲。在年龄≥65 岁的患者中，超过推荐剂量（格列美脲>1 毫克/天，格列齐特>40 毫克/天）的比例格列美脲（25.0%）高于格列齐特（7.8%）。在 65 岁至结论年龄段的患者中，最常见的处方模式是磺脲类药物、二肽基肽酶-4 抑制剂、钠-葡萄糖转运体 2 抑制剂和双胍类药物的四联疗法：对现实世界中磺脲类药物处方数据的分析发现了不遵守指南的情况，即格列美脲处方过多、老年患者使用格列本脲以及与二肽基肽酶-4 抑制剂共同处方的情况。这些发现可能为重新考虑对磺脲类药物处方过多的 2 型糖尿病患者的治疗提供了机会，以减少低血糖等残余风险。

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来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).