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

Figures & data

Figure 1 Analyses cohort diagram.

Note: Specialist here refers to a diabetes specialist (diabetologist, endocrinologist).
Abbreviations: PCP, primary care physician; T2DM, type 2 diabetes mellitus.

Table 1 Demographics and clinical characteristics by survey year of patients with T2DM treated by PCPs and specialists

Characteristic	Survey year
	2000	2002	2004	2006	2008	2009	2010	2011	2012	2013	2014	2015
Patients treated by PCPs
Age (years), mean (SD), n	61.1 (13.0), 2,939	62.3 (12.3), 2,218	62.8 (12.4), 2,214	62.8 (11.8), 2,539	62.6 (11.9), 2,593	62.7 (12.0), 2,756	61.8 (12.1), 2,965	62.2 (12.2), 3,065	61.2 (12.0), 3,056	61.4 (11.9), 4,628	61.6 (11.9), 4,726	61.7 (12.0), 4,726
Male, %, n	54.0, 2,939	53.5, 2,216	54.7, 2,215	51.4, 2,485	52.6, 2,528	54.4, 2,684	55.8, 2,937	55.6, 3,064	54.3, 3,046	54.9, 4,659	53.6, 4,750	54.2, 4,726
Age at diagnosis (years), mean (SD), n	53.4 (12.4), 2,439	55.5 (11.2), 1,950	56.3 (11.6), 1,959	57.5 (11.1), 2,337	56.9 (11.1), 2,445	57.3 (11.5), 2,586	56.3 (11.1), 2,623	56.5 (11.6), 2,737	56.3 (11.0), 2,734	56.1 (10.8), 4,069	56.3 (10.8), 4,178	56.2 (11.1), 3,911
Body mass index, (kg/m^2), mean (SD), n	29.5 (6.1), 2,856	29.5 (8.1), 2,189	29.5 (6.1), 2,181	29.4 (5.9), 2,508	29.1 (5.9), 2,554	29.4 (5.9), 2,685	29.8 (6.0), 2,929	29.5 (5.7), 3,016	29.3 (5.6), 2,998	29.5 (5.7), 4,578	30.0 (5.9), 4,522	29.8 (5.6), 4,655
Most recent HbA1c result (%), mean (SD), n	7.7 (1.6), 2,219	7.5 (1.6), 1,971	7.3 (1.5), 2,019	7.2 (1.2), 2,386	7.2 (1.2), 2,447	7.2 (1.1), 2,575	7.1 (1.2), 2,776	7.2 (2.5), 2,925	7.1 (1.0), 2,901	7.1 (1.1), 4,573	7.2 (1.1), 4,665	7.2 (1.3), 4,644
Antidiabetic drugs, mean (SD), n	1.4 (0.5), 2,942	1.6 (0.6), 2,219	1.5 (0.6), 2,215	1.6 (0.6), 2,539	1.6 (0.6), 2,593	1.6 (0.7), 2,756	1.6 (0.7), 2,966	1.6 (0.7), 3,067	1.6 (0.6), 3,057	1.6 (0.7), 4,659	1.6 (0.7), 4,750	1.7 (0.8), 4,726
Patients treated by specialists
Age (years), mean (SD), n	60.0 (12.7), 1,942	60.1 (12.5), 2,096	60.5 (12.9), 2,133	60.6 (11.6), 2,321	61.1 (12.7), 2,459	60.5 (12.2), 2,523	60.0 (12.6), 3,090	59.9 (12.9), 3,143	59.8 (12.4), 3,155	59.6 (12.3), 3,050	59.1 (12.0), 3,080	59.0 (12.4), 3,151
Male, %, n	54.9, 1,941	53.6, 2,096	52.5, 2,131	53.3, 2,288	54.0, 2,401	52.8, 2,469	52.8, 3,043	54.8, 3,142	54.8, 3,143	53.9, 3,058	54.2, 3,086	54.3, 3,151
Age at diagnosis (years), mean (SD), n	52.0 (12.3), 1,777	52.9 (11.3), 1,976	52.8 (11.9), 1,999	53.7 (12.1), 2,237	53.7 (12.1), 2,388	53.7 (11.5), 2,400	53.1 (11.8), 2,870	53.1 (11.9), 2,923	53.2 (11.6), 2,841	53.1 (11.4), 2,763	52.7 (10.9), 2,784	52.8 (11.5), 2,758
Body mass index (kg/m^2), mean (SD), n	29.8 (5.8), 1,853	30.1 (6.8), 2,055	29.9 (6.1), 2,058	29.6 (6.1), 2,279	29.7 (6.1), 2,408	30.1 (5.8), 2,447	30.0 (6.0), 3,016	30.1 (5.9), 3,078	30.7 (6.1), 3,099	30.7 (6.2), 3,001	30.9 (6.3), 2,907	30.6 (6.0), 3,065
Recent HbA1c result (%), mean (SD), n	7.8 (1.6), 1,650	7.7 (1.4), 1,949	7.6 (1.5), 1,998	7.5 (1.3), 2,231	7.5 (1.4), 2,374	7.5 (1.3), 2,385	7.5 (1.4), 2,908	7.7 (3.7), 3,036	7.5 (1.2), 3,066	7.4 (1.4), 3,043	7.6 (1.4), 3,050	7.6 (1.5), 3,120
Antidiabetic drugs, mean (SD), n	1.6 (0.6), 1,944	1.8 (0.6), 2,097	1.8 (0.6), 2,135	1.9 (0.7), 2,322	1.9 (0.7), 2,459	2.0 (0.7), 2,523	1.9 (0.8), 3,090	2.0 (0.8), 3,145	2.0 (0.8), 3,156	2.0 (0.9), 3,060	1.9 (0.9), 3,086	2.1 (0.9), 3,151

Abbreviations: T2DM, type 2 diabetes mellitus; PCPs, primary care physicians; SD, standard deviation; HbA_1c, glycated hemoglobin.

Figure 2 Combination regimens used for the treatment of patients with T2DM between 2000 and 2015 for (A) PCPs and (B) specialists.

Notes: All patients were receiving ≥1 non-insulin antidiabetic treatment and could also have been receiving insulin, but insulin-only patients were excluded. Older OADs category includes prandial glucose regulators, alpha-glucosidase inhibitors, TZDs, and combinations with metformin and SU. All other OADs are included in the “other non-insulin regimens” (including DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors). Data collected in Diabetes Disease Specific Programme 2000–2015, physician-completed patient record form. Base: all patients receiving a non-insulin ± insulin regimen from surveys conducted in 2000 (n=4,886), 2002 (n=4,316), 2004 (n=4,350), 2006 (n=4,861), 2008 (n=5,052), 2009 (n=5,279), 2010 (n=6,055), 2011 (n=6,212), 2012 (n=6,213), 2013 (n=7,719), 2014 (n=7,836), 2015 (n=7,877).
Abbreviations: T2DM, type 2 diabetes mellitus; PCP, primary care physician; OADs, oral antidiabetic drugs; TZDs, thiazolidinediones; SU, sulfonylurea; DPP-4, dipeptidyl peptidase 4 inhibitor; GLP-1, glucagon-like peptide 1; SGLT-2, sodium–glucose cotransporter 2 inhibitor.

Figure 3 Time to initiation of insulin in patients with T2DM for (A) PCPs and (B) specialists.

Notes: All patients were receiving ≥1 non-insulin antidiabetic treatment and could also have been receiving insulin, but insulin-only patients were excluded. As time to diagnosis of T2DM to the survey date was different in each patient within each wave, time to initiation of insulin was compared for the year the patient was diagnosed, rather than the survey year in which the patient was included. Data collected in Diabetes Disease Specific Programme 2011–2015, physician-completed patient record form. Base: year of diagnosis: pre-1999 (n=2,032), 2000–2003 (n=2,695), 2004–2007 (n=4,959), 2008–2011 (n=10,264), 2012–2015 (n=7,456).
Abbreviations: T2DM, type 2 diabetes mellitus; PCPs, primary care physicians.

Figure 4 HbA_1c levels in patients with T2DM treated by (A) PCPs and (B) specialists.

Notes: All patients were receiving ≥1 non-insulin antidiabetic treatment and could also have been receiving insulin, but excluded insulin-only patients. Data collected in Diabetes Disease Specific Programme 2000–2015, physician-completed patient record form. Base: all patients with stated most recent HbA_1c from surveys conducted in 2000 (n=3,869), 2002 (n=3,920), 2004 (n=4,017), 2006 (n=4,617), 2008 (n=4,821), 2009 (n=4,960), 2010 (n=5,817), 2011 (n=5,961), 2012 (n=5,967), 2013 (n=7,616), 2014 (n=7,715), 2015 (n=7,764).
Abbreviations: HbA_1c, glycated hemoglobin; T2DM, type 2 diabetes mellitus; PCPs, primary care physicians.