Trends in Antidiabetic Medication Prescribing: A Review of the Past 10 years among Specialists (Vol. 3)

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CareNet previously conducted the “White Paper on Diabetes,” an online survey of physicians involved in diabetes treatment over the past 10 years.

CareNet also planned an academic paper, titled “Trends in Antidiabetic Medication Prescribing: A Review of the Past 10 Years among Specialists,” which analyzed the results of the “White Paper on Diabetes” survey and was published in 2022.

The third issue focuses on the “Percentage of use for Different Second-Line Prescriptions of Antidiabetic Medications [treatment changes from dipeptidyl-peptidase 4 inhibitors (DPP-4 inhibitors)].”

We plan to introduce the prescription trends over the past 10 years based on the results of a survey on “second-line medications prescribed to patients when glycemic control is inadequate after using first-line DPP-4 inhibitor monotherapy.”

[Previous postings]

Vol.1 Important Considerations in Medication Selection

Vol.2 Percentage of use for Different First-Line Prescriptions of Antidiabetic Medications

Percentage of use for Different Second-Line Prescriptions of Antidiabetic Medications (treatment changes from DPP-4 inhibitors)

In this paper, we analyzed medications that were added or changed prescriptions when DPP-4 inhibitors were first-line medications and identified the prescription trends.

In 2012, the top three medications prescribed as treatment options for inadequate responses to DPP-4 inhibitors were “Add sulfonylureas(SU)” (31.9%), “Add biguanides(BG)” (31.0%), and “Switch to other medications” (13.4%).

On the other hand, the top three medications prescribed as treatment options in 2021 were “Add BG” (37.1%), “Add sodium-dependent glucose transporter 2 inhibitors (SGLT2 inhibitors)” (22.0%), and “Switch to DPP-4 inhibitors/BG combination medications” (13.7%).

Compared with 10 years ago, there has been a decrease in “Add SU,” while new options such as “Add SGLT2 inhibitors” and “Switch to combination medications” have increased.

In contrast, “Add BG” did not change significantly over the 10 years, remaining at 30-40%(Figure 2).

Since 2015, there has been a decrease in “Add SU” and an increase in “Add SGLT2 inhibitors.” Since 2018, “Switch to DPP-4 inhibitors/BG combination medications” has increased every year.

When DPP-4 inhibitors were the first-line prescriptions of antidiabetic medications, the most popular second-line medication was “Add BG” (during 2013-2021).

Since many combination medications of BG and DPP-4 inhibitors are already in use, it is assumed that the combination of these two medications provides reasonable action.¹⁾

[Reference]

1)Tanabe, M., Motonaga, R. et al.: Prescription of oral hypoglycemic agents for patients with type 2 diabetes mellitus: A retrospective cohort study using a Japanese hospital database. J Diabetes Investing, 8: 227~234, 2017.

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