Characterization of treatment intensified (add-on to metformin) adults with type 2 diabetes in Thailand: A cross-sectional real-world study (CONVERGE)

Abstract

Objective

The CONVERGE (Cardiovascular Outcomes and Value in the Real-World with GLP-1RAs) study characterized demographics, clinical characteristics, and medication use in treatment-intensified (add-on to metformin) adults with type 2 diabetes (T2D) in Thailand.

Methods

A retrospective cross-sectional study of data from medical records (Jul 26, 2013, to Dec 31, 2017) was descriptively summarized for overall population and subgroups defined by glucose-lowering agent (GLA) classes.

Results

Data from 1,000 adults were collected in reverse chronological order. At baseline, the mean (SD) age was 60 (12) years, HbA_1c was 8.0%, and the median (IQR) T2D duration was 1.0 (0.2–2.4) years. Patients taking SGLT2-is (sodium glucose cotransporter-2 inhibitors) had a longer T2D duration (1.8 years, 0.8–3.2), GLP-1RAs (glucagon-like peptide-1 receptor agonists) had a higher body mass index of 32.0 (8.84) kg/m², and insulin subgroup had a higher HbA_1c 8.5% (7.5–10.1). The utilization of GLP-1 RAs/SGLT-2is was low (1.5% and 6%, respectively). Among the subgroups, most patients in the GLP-1RA (80.0%) and insulin subgroup (81.3%) receiving 3/≥4 GLAs. The most frequently prescribed GLAs post-metformin were sulfonylureas (45.2%) and dipeptidyl peptidase-4 inhibitors (39.4%). Overall, 90% received ≥1 cardiovascular (CV) medication; lipid-lowering agents (78%) were the most prescribed.

Conclusions

These results indicate low utilization of GLAs with CV benefits, attributed to a lack of CV benefit data during the study period and partial reimbursement implementation. Future studies must identify barriers to adoption and estimate the usage of these GLAs with CV benefits as more evidence becomes available on positive CV outcomes to improve patient care in Thailand.