Treatment modification after initiating second-line medication for type 2 diabetes
Objectives: To explain alterations in antidiabetic medication (ADM) use and characteristics connected with alterations in ADM use after initiation of noninsulin second-line therapy.
Study design: Retrospective cohort study.
Methods: This research examined private health plan claims for adults with diabetes type 2 who initiated 1 of 5 index ADM classes: sulfonylureas, dipeptidyl peptidase 4 inhibitors (DPP4is), sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), or thiazolidinediones. Analyses evaluated 3 treatment modification outcomes-stopping, switching, and intensification-over 12-month follow-up.
Results: Of 82,624 incorporated adults, nearly two-thirds (63.6%) experienced CF-102 agonist any treatment modification. Stopping was the most typical modification (38.6%), especially among patients prescribed GLP-1 RAs (50.3%). Switching happened in five.2% of patients and intensification in 19.8%. In adjusted analysis, in contrast to patients prescribed sulfonylureas, stopping risk was 7% greater (HR, 1.07 95% CI, 1.04-1.10) among patients prescribed DPP4is and 28% greater (HR, 1.28 95% CI, 1.23-1.33) among patients prescribed GLP-1 RAs. In contrast to sulfonylureas, other index ADM classes had greater perils of switching minimizing perils of intensification. More youthful age bracket and feminine sex were both connected with greater perils of all modifications. In contrast to index ADM prescription with a family medicine or internal medicine physician, index prescription by an endocrinologist was connected with lower stopping risk and greater intensification risk.
Conclusions: Most sufferers possessed a treatment modification within 12 months. Results highlight the requirement for new prescribing approaches and patient supports that may maximize medication adherence and lower health system waste.