Objectives To assess trends in prescribing practices of antidiabetic agents and glycaemic control in patients with type 2 diabetes mellitus (T2DM).
Design Cross-sectional analysis using yearly clinical data and antidiabetic treatments prescribed obtained from an electronic population database.
Setting Primary healthcare centres, including the entire population attended by the Institut Català de la Salut in Catalonia, Spain, from 2007 to 2013.
Participants Patients aged 31–90 years with a diagnosis of T2DM.
Results The number of registered patients with T2DM in the database was 257 072 in 2007, increasing up to 343 969 in 2013. The proportion of patients not pharmacologically treated decreased by 9.7% (95% CI −9.48% to −9.92%), while there was an increase in the percentage of patients on monotherapy (4.4% increase; 95% CI 4.16% to 4.64%), combination therapy (2.8% increase; 95% CI 2.58% to 3.02%), and insulin alone or in combination (increasing 2.5%; 95% CI 2.2% to 2.8%). The use of metformin and dipeptidyl peptidase-IV inhibitors increased gradually, while sulfonylureas, glitazones and α-glucosidase inhibitors decreased. The use of glinides remained stable, and the use of glucagon-like peptide-1 receptor agonists was still marginal. Regarding glycaemic control, there were no relevant differences across years: mean glycated haemoglobin (HbA1c) value was around 7.2%; the percentage of patients reaching an HbA1c≤7% target ranged between 52.2% and 55.6%; and those attaining their individualised target from 72.8% to 75.7%.
Conclusions Although the proportion of patients under pharmacological treatment increased substantially over time and there was an increase in the use of combination therapies, there have not been relevant changes in glycaemic control during the 2007–2013 period in Catalonia.
- glycemic control
- Type 2 diabetes mellitus
- PRIMARY CARE
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Contributors MM-C and JF-N wrote the manuscript and contributed equally to this study. JR managed the database, performed the statistical analyses and contributed to the discussion. JF-N, MM-C and DM conceived the study, participated in the study design, contributed to data cleaning, analysis and interpretation, reviewed/edited the manuscript and contributed to the discussion. MM-C had full access to all data in the study and takes responsibility for the integrity of data and the accuracy of the data analysis.
Funding This study was funded by Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), and an unrestricted grant provided by Astra Zeneca.
Disclaimer The funding sources had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review or approval of the manuscript.
Competing interests None declared.
Ethics approval Ethics Committee of the Primary Health Care University Research Institute (IDIAP) Jordi Gol.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.