ArticleDiabetes, obesity, and cardiometabolic CARE
Trends in Diabetes Medications After Metformin in Patients at High Versus Moderate Cardiovascular Risk: The BESTMED Consortium 2014-2022.
Article in Diabetes, obesity, and cardiometabolic CARE. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
objectiveTo compare nationwide prescription trends in medications (dipeptidyl peptidase 4 inhibitors [DPP-4i], glucagon-like peptide 1 receptor agonists [GLP-1 RAs], sodium-glucose cotransporter 2 inhibitors [SGLT2i], or sulfonylureas [SUs]) after treatment with metformin in patients with type 2 diabetes (T2D) at high versus moderate cardiovascular risk by key sociodemographic and health characteristics. RESEARCH DESIGN AND
methodsElectronic health records and insurance claims from 2014 to 2022 from 10 health systems and two insurance plans from different U.S. regions were evaluated. Risk-stratified multinomial log-linear models were used to model trends in prescribing patterns, adjusted for sociodemographic variables.
resultsA total of 104,474 patients were included (28% at high and 72% at moderate cardiovascular risk). Among those at high cardiovascular risk, DPP-4i (2014 24.0%; 2022 11.0%) and SU (66.4%; 35.7%) prescriptions declined, whereas GLP-1 RA (4.4%; 20.5%) and SGLT2i (5.2%; 32.8%) prescriptions increased. Among those at moderate cardiovascular risk, DPP-4i (23.7%; 11.7%) and SU (63.7%; 31.5%) prescriptions declined, whereas GLP-1 RA (5.7%; 30.0%) and SGLT2i (6.9%; 26.8%) prescriptions increased. Annual increases differed by high versus moderate cardiovascular risk for GLP-1 RAs (+2.5% vs. +3.6%/year;
conclusionsPrescribing patterns for second-line T2D therapies in those at moderate cardiovascular risk are approaching guideline recommendations for those at high risk. Some trends are potentially clinically explainable, whereas certain racial/ethnic differences may warrant exploration. Video 1.Video abstract3e51f820-63ec-4c76-86f4-002f78d7c5f0doc260027video1.
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