Objective To explore the 'real-life' therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others, new users of OADs were identified in the period 1999-2004. New users, aged 30 years and older, without insulin use before cohort entry date and with at least one year follow-up were included. We determined per initial therapy patient characteristics and first therapy change. Results Overall 35,514 patients were included. Metformin and sulfonylureas (SU) were the most frequent initial therapy. Patients on thiazolidinedione (TZD) monotherapy had lower percentages baseline HbA1c ≥ 7% compared to patients on metformin and SU. The proportion of patients still on initial therapy after one year ranged from 46% (TZDs) to around 60% (SU). Among patients starting on monotherapy, add-on (15-20%) and discontinuation (16-25%) of therapy occurred most frequently. In patients starting on combination therapy, a switch occurred in 30% of the patients. Conclusion In more than 40% of the patients a change in initial OAD-therapy is already observed in the first year of therapy. Maintaining patients on initial therapy remains a challenge.

Diabetes, Netherlands, Oral antidiabetic agents, Pharmacoepidemiology, Treatment pattern, acarbose, adult, aged, antidiabetic agent, article, cohort analysis, controlled study, diabetic patient, drug efficacy, drug withdrawal, female, glitazone derivative, hemoglobin A1c, human, insulin, major clinical study, male, metformin, monotherapy, non insulin dependent diabetes mellitus, sulfonylurea derivative
dx.doi.org/10.1007/s11096-009-9321-0, hdl.handle.net/1765/19616
Pharmacy World and Science
Erasmus MC: University Medical Center Rotterdam

Plat, A, Penning-Van Beest, F.J.A, Kessabi, S, Groot, M.T, & Herings, R.M.C. (2009). Change of initial oral antidiabetic therapy in type 2 diabetic patients. Pharmacy World and Science, 31(6), 622–626. doi:10.1007/s11096-009-9321-0