Regional differences in type 2 diabetes treatment and outcomes in Germany—An analysis of the German DPV and DIVE registries

Hartmann, Bettina; Bramlage, Peter; Lanzinger, Stefanie; Danne, Thomas; Hummel, Michael; Kaltheuner, Matthias; Roggenbuck, Dirk; Rathmann, Wolfgang; Reuter, Hans-Martin; Seufert, Jochen; Holl, Reinhard W.

doi:10.1002/dmrr.3049

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…Our data suggested that treatment strategies with DPP-4is were increasingly preferred for newly diagnosed diabetes over strategies with sulfonylureas, confirming previous reports on populations of known diabetes cases in general practices (2008-2016) [8] and in outpatient clinics in Germany (2014-2016) [9]. Also, the observed downward trends in dispensation frequencies of both monotherapy and combination therapy with sulfonylureas had been previously observed in general practice [8].…”

Section: Discussionsupporting

confidence: 89%

“…Since this study only reported how frequently a certain drug had been prescribed in total, without distinguishing between specific mono-and combination therapies, a further comparison of distinct treatment strategies was not possible. The study that reported on glucose-lowering therapy in German outpatient clinics had not analyzed treatment patterns at multiple time points [9].…”

Section: Discussionmentioning

confidence: 99%

“…A drawback of these data is that they do not provide the full treatment history of an individual since German citizens are free to change their treating physician at any time; consequently, only cases with known diabetes can be analyzed [8]. Glucose-lowering prescription patterns in Germany have further been analyzed using data from two diabetes registries, which comprise data from outpatient clinics throughout Germany [9]. Yet, these hospital-based data too, include individuals with known diabetes only.…”

Section: Introductionmentioning

confidence: 99%

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Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

Bongaerts

Kollhorst

Kuß

et al. 2021

Exp Clin Endocrinol Diabetes

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Aims To describe dispensation patterns of glucose-lowering drugs in newly diagnosed type 2 diabetes in Germany. Materials and methods Based on claims data from four statutory health insurances (German Pharmacoepidemiological Research Database,>25 million insurants), all individuals with newly diagnosed type 2 diabetes were identified. Eligible patients had a first diagnosis for type 2 diabetes between January 2012 and December 2016. We analyzed the dispensation patterns of first-line glucose-lowering therapies initiated in the year after diabetes diagnosis and patterns of second-line therapies dispensed one year after first-line treatment. Results A total of 356,647 individuals with newly diagnosed type 2 diabetes were included (average age [SD]: 63.5 [13.4] years; 49.3% males). Of the 31.6% of individuals who were pharmacologically treated in the year after diagnosis, metformin monotherapy was most frequently dispensed (73.1%), followed by dual therapy of metformin and dipeptidyl peptidase-4 inhibitors (DPP-4is) (6.4%), and monotherapy with DPP-4is (2.9%). From 2012 through 2016, sulfonylurea dispensations were reduced by more than 50%. Dispensations for combination therapies with DPP-4is increased up to 10.6%. Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors contributed to 2% of all treatments. After a median of 5 months, 20.0% of individuals on pharmacological therapy initiated second-line glucose-lowering treatment. Conclusions Data from German statutory health insurances (2012 to 2016) showed that most individuals with newly diagnosed type 2 diabetes were dispensed metformin monotherapy in line with diabetes care guidelines. A substantial decrease in the use of sulfonylureas was observed after the introduction of DPP-4i and GLP-1 receptor agonists.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

Bongaerts

Kollhorst

Kuß

et al. 2021

Exp Clin Endocrinol Diabetes

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“… 6 7 10 11 Despite its consideration later in therapy, insulin is still common in the treatment of type 2 diabetes worldwide, ranging from 30% to 40%. 37 42 Insulin showed no significant changes from 2012 to 2018 ( figure 1 ), and insulin is still the second most common antidiabetic drug ( table 2 ) in the DRT. 28 Although insulin and sulfonylureas share a higher risk for hypoglycemia, sulfonylurea prescriptions were decreasing while insulin remained stable ( figure 1 ).…”

Section: Discussionmentioning

confidence: 96%

“…Since 2012, metformin has shown strong increases, is the most prevalent drug and is more often used in younger patients. [34][35][36][37][38] Since the last DRT publication data have shown that metformin is now the most prevalent antidiabetic medication throughout every age group. 28 Approval in CKD, decreased CV mortality in monotherapy and combination therapy, same glycemic results as glitazones and sulfonylureas, higher effectiveness than gliptins, increasing long-term data and physician experience made metformin applicable to all age groups and substantiated the increase in use of metformin in the treatment of type 2 diabetes.…”

Section: Metforminmentioning

confidence: 99%

Long-term trends in the prescription of antidiabetic drugs: real-world evidence from the Diabetes Registry Tyrol 2012–2018

Engler

Leo

Pfeifer

et al. 2020

BMJ Open Diab Res Care

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IntroductionPrescription patterns of antidiabetic drugs in the period from 2012 to 2018 were investigated based on the Diabetes Registry Tyrol. To validate the findings, we compared the numbers with trends of different national registries conducted in a comparable period of time.Research design and methodsMedication data, prescription patterns, age groups, antidiabetic therapies and quality parameters (hemoglobin A1c, body mass index, complications) of 10 875 patients with type 2 diabetes from 2012 to 2018 were retrospectively assessed and descriptively analyzed. The changes were assessed using a time series analysis with linear regression and prescription trends were plotted over time.ResultsSodium/glucose cotransporter 2 inhibitors (SGLT-2i) showed a significant increase in prescription from 2012 to 2018 (p<0.001), as well as metformin (p=0.002), gliptins (p=0.013) and glucagon-like peptide-1 agonists (GLP-1a) (p=0.017). Significant reduction in sulfonylurea prescriptions (p<0.001) was observed. Metformin was the most frequently prescribed antidiabetic drug (51.3%), followed by insulin/analogs (34.6%), gliptins (28.2%), SGLT-2i (11.7%), sulfonylurea (9.1%), glitazones (3.7%), GLP-1a (2.8%) and glucosidase inhibitors (0.4%).ConclusionsIn this long-term, real-world study on prescription changes in the Diabetes Registry Tyrol, we observed significant increase in SGLT-2i, metformin, gliptins and GLP-1a prescriptions. In contrast prescriptions for sulfonylureas declined significantly. Changes were consistent over the years 2012–2018. Changes in prescription patterns occurred even before the publication of international and national guidelines. Thus, physicians change their prescription practice not only based on published guidelines, but even earlier on publication of cardiovascular outcome trials.

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Welche Patienten mit Typ-2-Diabetes bekommen neue Antidiabetika?

et al. 2018

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Regional differences in type 2 diabetes treatment and outcomes in Germany—An analysis of the German DPV and DIVE registries

Abstract: Federal states in Germany are heterogeneous concerning diabetes treatment and associated outcomes. These data should stimulate further discussion about how optimal diabetes care can be implemented in all areas of Germany, to achieve good treatment outcomes in all federal states.

Cited by 8 publications

References 38 publications

Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

Dispensation Patterns of Glucose-Lowering Drugs in Newly Diagnosed Type 2 Diabetes: Routine Data Analysis of Insurance Claims in Germany

Long-term trends in the prescription of antidiabetic drugs: real-world evidence from the Diabetes Registry Tyrol 2012–2018

Welche Patienten mit Typ-2-Diabetes bekommen neue Antidiabetika?

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