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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 fourth issue focuses on the “Percentage of use for Different Second-Line Prescriptions of Antidiabetic Medications [treatment changes from biguanides (BG)].”

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

[Previous postings]

Vol.1 Important Considerations in Medication Selection

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

Vol.3 Percentage of use for Different Second-Line Prescriptions of Antidiabetic Medications (treatment changes from DPP-4 inhibitors)

“Percentage of use for Different Second-Line Prescriptions of Antidiabetic Medications (treatment changes from BG)”

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

In 2012, the top three medications prescribed as treatment options for inadequate response to BG were “Add dipeptidyl-peptidase 4 inhibitors(DPP-4 inhibitors)” (34.1%), “Add sulfonylureas (SU)” (24.9%), and “Switch to non-DPP-4 inhibitors(other than combination medications)” (9.2%).

On the other hand, the top three medications prescribed as treatment options in 2021 were “Add DPP-4 inhibitors” (44.1%), “Add sodium-dependent glucose transporter 2 inhibitors (SGLT2 inhibitors)” (27.0%), and “Switch to BG/DPP-4 inhibitors combination medications” (13.4%).

Similar to the treatment changes from DPP-4 inhibitors (see Vol. 3), there was a decrease in “Add SU” and an increase in “Add SGLT2 inhibitors” and “Switch to combination medications” (Figure 3).

The prescription of SGLT2 inhibitors has risen in recent years.

SGLT2 inhibitors have attracted considerable attention due to their ability to prevent recurrent and renal events in patients with a history of cardiovascular events. It is thought that they were selected in anticipation of their ability to prevent such complications.

figure3

【Figure 3】 Yearly changes in the percentage of second-line prescriptions

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