Trends in Antidiabetic Medication Prescribing: A Review of the Past 10 years among Specialists (Vol.1)

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

Given that the year 2021 marked the 100th anniversary of the discovery of insulin, CareNet 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 over the past 10 years, and published in 2022.

This paper was co-authored by Dr. Ryuzo Kawamori, a specially appointed professor at the Juntendo University Graduate School of Medicine.

[Outline of Academic Paper]

The paper analyzed responses to the following four questions surveyed in the “White Paper on Diabetes.”

■The most important items when selecting and prescribing oral medications to treat diabetes.
■First-line medications prescribed to patients with inadequate glycemic control with dietary measures and exercise therapy.
■Medications to be prescribed as second-line treatment when glycemic control is inadequate despite first-line dipeptidyl peptidase 4(DPP-4) inhibitor administration as a single agent.
■Medications to be prescribed as second-line treatment when glycemic control is inadequate despite first-line biguanides(BG) administration as a single agent.

The “White Paper on Diabetes” survey targeted CareNet member physicians who see at least 10 patients with type 2 diabetes per month.

In the paper, the full analysis was based on the results of responses provided by physicians affiliated with the Department of Diabetes, Metabolism, and Endocrinology from the white paper (2,122 [36%] of the total number of 5,973 survey participants were selected).

The responding physicians had approximately 200–300 patients on average.

Important Considerations When Selecting and Prescribing Oral Antidiabetic Medications

To determine “how diabetes treatment has changed with the development of medications with different mechanisms of action,” we analyzed prescriptions of antidiabetic medications from 2009 to 2021 and identified changes in prescription trends over the past 10 years.

In the first article in this series, we plan to introduce “Important Considerations When Selecting and Prescribing Oral Antidiabetic Medications, ” which suggests that trends for certain items have changed while others have remained unchanged for 10 years.

Important Considerations in Medication Selection

On analyzing the differences in important considerations for selecting antidiabetic medications between 2012 and 2021, the results revealed that the top items were not significantly altered between the two years, with “less likely to cause hypoglycemia” and “less likely to cause weight gain” being the two most important items.

Other common items selected by more than 60% of respondents in both years were “no serious side effects” and “improves insulin resistance;” however, in 2021, “easy to use for the elderly patients” and “easy to use for patients with impaired renal function” were the most popular features (Table).

The results suggest that antidiabetic medications are also essential to prevent and manage comorbidities, such as cancer, dementia, and complications in various organs in patients with diabetes.

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