Contemporary trends in the utilization of second‐line pharmacological therapies for type 2 diabetes in the United States and the United Kingdom
Authors' conclusion
This international cohort study shows that sulphonylureas remain the most common second-line medications prescribed following metformin in both the United States and the United Kingdom. Despite recommendations, the use of newer glucose-lowering therapies with cardiovascular benefits remains low.
Study context
- Population
- Adults with T2D initiating first-line metformin or SU monotherapy, 2013–2019, followed through June 2021; US Optum Clinformatics and UK Clinical Practice Research Datalink
- Participants
- 148,511 vs 169,316
- Exposure
- United States vs United Kingdom
- United Statesn = 148,511
- United Kingdomn = 169,316
- Outcome
- Patterns of second-line glucose-lowering medications after first-line metformin
- Follow-up
- Through June 2021
Methodological detailsinternational, stratified by cardiovascular disease (CVD) and calendar time
- International
- Stratified by CVD and calendar time
Main finding
As reported in the abstract
Most frequently initiated second-line medications after metformin · throughout the study period
SU
DPP-4i
Observational data: associations, not effects.
Further findings
Second-line SGLT2i and GLP-1 RA use after 2018, and by CVD
- SGLT2i and GLP-1 RA more commonly used as second-line agents in US and UK, but not preferentially prescribed in patients with CVD
First-line SU initiators
- First-line SU initiation much less common; most SU initiators had metformin added as second-line agent
Original publication
Contemporary trends in the utilization of second‐line pharmacological therapies for type 2 diabetes in the United States and the United Kingdom. Diabetes Obes Metab. Published 3 July 2023. doi:10.
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