Changes in antidiabetic drug prescription patterns during follow-up of the GERODIAB cohort. Comparison with professional recommendations

Introduction

The aim of the present study was to analyse the changes in antidiabetic drug prescription patterns during the follow-up of the GERODIAB cohort between 2009 and 2015 and to compare them with the available professional recommendations.

Patients and methods

The present study included 637 type 2 diabetic patients aged 70 years and over who have survived after 5 years. We compared the three main types of therapeutic modalities: (1) insulin only; (2) combination of insulin and one or more oral antidiabetic drugs (OADs) and/or glucagon-like peptide-1 receptor agonists (GLP-1RAs); and (3) treatment with one or more OADs and/or GLP-1RAs without insulin. We analysed changes in the antidiabetic drug classes, notably the antidiabetic drugs exposing patients to hypoglycaemia. Finally, we analysed changes in the prescriptions of patients initially treated with antidiabetic monotherapy.

Results

At inclusion, 25.6% patients were receiving only insulin, 30.9% patients were receiving insulin and OADs and/or GLP-1RAs, and 42.5% patients were receiving OADs and/or GLP-1RAs without insulin. At the final visit, 69.5% of patients continued to receive the same treatment modality. Only the number of patients treated with insulin alone increased (+9.9%). Prescriptions of insulin increased and prescriptions of OADs or GLP-1RAs decreased. The total drugs exposing patients to hypoglycaemia remained constant. Prescriptions of metformin remained high, prescriptions of sulfonylureas and glinides decreased and those of DPP-4 inhibitors increased.

Discussion - Conclusion

The increased prescription of insulin was predictable. Prescriptions of sulfonylureas and glinides remained relatively high, although recommendations for these drugs continue to decline.