Trends in medication use in patients with type 2 diabetes mellitus: a long-term view of real-world treatment between 2000 and 2015

Abstract

Background

Despite the availability of a variety of treatments, many patients with type 2 diabetes mellitus (T2DM) are not achieving glucose control. We analyzed successive waves of the Adelphi Real World Diabetes Disease Specific Programmes (DSPs) to assess treatment patterns reported by primary care physicians (PCPs) and specialists and the effect of treatment on levels of glucose control.

Methods

Data were collected between 2000 and 2015 in the US and EU5 (France, Germany, Italy, Spain, and the UK). Physicians completed patient record forms for the next 10 patients consulting with T2DM. Key aspects captured were change over time in therapy usage, time to insulin introduction, and glycated hemoglobin (HbA_1c) levels.

Results

Over 12 DSP waves, 3,555 specialists and 5,109 PCPs completed questionnaires for 70,657 patients. Treatment patterns changed considerably over time as new agents were introduced. The number of agents prescribed per patient increased over time, as did HbA_1c levels at which physicians stated they would introduce insulin. The greatest improvements in HbA_1c levels occurred during 2000–2008, with little improvement since 2008.

Conclusion

In this real-world setting, the proportion of patients with T2DM achieving good glucose control has not increased greatly since 2008. A better understanding of how to individualize treatment pathways may be required to improve control in these patients.

Keywords:

• insulinization
• real world
• type 2 diabetes
• treatment trends

Acknowledgments

The authors would like to thank Deirdre Carman for editorial assistance in the preparation of this manuscript. Adelphi Real World designed the data collection tools, run the fieldwork and own the data.

Disclosure

The authors received no sponsorship or any outside funding or involvement in setting the research objectives, for this analysis and publication. The authors are employed by Adelphi Real World. The authors report no other conflicts of interest in this work.