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Treatment patterns and glycated haemoglobin levels over 36 months in individuals with type 2 diabetes initiating second-line glucose-lowering therapy: The global DISCOVER study

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posted on 2023-01-20, 16:45 authored by Bernard H Charbonnel, Hungta Chen, Javier Cid-Ruzafa, Andrew Cooper, Peter Fenici, Marilia B Gomes, Gabriela L Saraiva, Jesus Medina, Antonio Nicolucci, Marina Shestakova, Iichiro Shimomura, Filip Surmont, Fengming Tang, Jiten Vora, Hirotaka Watada, Kamlesh Khunti

Aims: To describe glucose-lowering treatment regimens and glycated haemoglobin (HbA1c) trajectories in individuals with type 2 diabetes (T2D) over 36 months of follow-up from the start of second-line therapy. 

Materials and Methods: This data analysis from the 3-year, observational DISCOVER study programme included 14 687 participants from 37 countries with T2D initiating second-line glucose-lowering therapy. Treatment and HbA1c data were collected at baseline (start of second-line therapy) and at 6, 12, 24 and 36 months. Treatment regimen changes over follow-up were analysed using the McNemar test, with carry-forward imputation for intermediate missing values. 

Results: A total of 11 592 participants had treatment data at baseline and 36 months, and 11 882 had HbA1c data at baseline. At baseline and 36 months, respectively, rates of oral monotherapy use were 12.1% and 12.4% (P = 0.22), rates of dual oral therapy use were 63.4% and 47.6% (P < 0.0001), rates of ≥ triple oral therapy use were 17.5% and 25.4% (P < 0.0001), and rates of injectable treatment use were 7.0% and 13.7% (P < 0.0001). Use of injectable drugs was most common among participants with an HbA1c level ≥64 mmol/mol (≥8.0%). Overall, 42.9% of participants changed treatment during follow-up. Mean HbA1c levels at baseline and 6 months were 67 mmol/mol (8.3%) and 55 mmol/mol (7.2%), respectively, remaining stable thereafter. 

Conclusions: Dual oral therapy was the most common treatment regimen at the start of second-line treatment, and over half of the participants remained on the same treatment during follow-up.

Funding

Kamlesh Khunti is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands and the NIHR Leicester Biomedical Reseach Centre.

History

Citation

Ruzafa J, et al. Treatment patterns and glycated haemoglobin levels over 36 months in individuals with type 2 diabetes initiating second-line glucose-lowering therapy: The global DISCOVER study. Diabetes Obes Metab. 2023;25(1):46‐ 5.doi:10.1111/dom.14842CHARBONNELET AL.55

Author affiliation

Diabetes Research Centre

Version

VoR (Version of Record)

Published in

DIABETES OBESITY & METABOLISM

Volume

25

Issue

1

Pagination

46 - 55

Publisher

WILEY

issn

1462-8902

eissn

1463-1326

Acceptance date

2022-08-16

Copyright date

2022

Available date

2023-01-20

Language

English