Factors associated with initiation of antihyperglycaemic medication in UK patients with newly diagnosed type 2 diabetes

被引:13
作者
Sinclair, Alan J. [2 ]
Alexander, Charles M.
Davies, Michael J.
Zhao, Changgeng
Mavros, Panagiotis [1 ]
机构
[1] Merck Sharp & Dohme Corp, Global Hlth Outcomes, Whitehouse Stn, NJ 08889 USA
[2] Beds & Herts Postgrad Med Sch, Luton, Beds, England
来源
BMC ENDOCRINE DISORDERS | 2012年 / 12卷
关键词
Clinical inertia; Age; Type 2 diabetes mellitus; Antihyperglycaemic medication; EUROPEAN-ASSOCIATION; CONSENSUS ALGORITHM; MANAGEMENT; THERAPY; MELLITUS; HYPERGLYCEMIA; ADJUSTMENT; STATEMENT; DIET; CARE;
D O I
10.1186/1472-6823-12-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To assess the factors associated with antihyperglycaemic medication initiation in UK patients with newly diagnosed type 2 diabetes. Methods: In a retrospective cohort study, patients with newly diagnosed type 2 diabetes were identified during the index period of 2003-2005. Eligible patients were >= 30 years old at the date of the first observed diabetes diagnosis (referred to as index date) and had at least 2 years of follow-up medical history (N = 9,158). Initiation of antihyperglycaemic medication (i.e., treatment) was assessed in the 2-year period following the index date. Adjusted Cox regression models were used to examine the association between time to medication initiation and patient age and other factors. Results: Mean (SD) HbA(1c) at diagnosis was 8.1% (2.3). Overall, 51% of patients initiated antihyperglycaemic medication within 2 years (65%, 55%, 46% and 40% for patients in the 30-<45, 45-<65, 65-<75, 75+ age groups, respectively). Among the treated patients, median (25th, 75th percentile) time to treatment initiation was 63 (8, 257) days. Of the patients with HbA(1c) >= 7.5% at diagnosis, 87% initiated treatment within 2 years. These patients with a higher HbA(1c) also had shorter time to treatment initiation (adjusted hazard ratio (HR) = 2.44 [95% confidence interval (CI): 1.61, 3.70]; p < 0.0001). Increasing age (in years) was negatively associated with time to treatment initiation (HR = 0.98 [95% CI: 0.97, 0.99]; p < 0.001). Factors significantly associated with shorter time to treatment initiation included female gender and use of cardiovascular medications at baseline or initiated during follow up. Conclusions: In this UK cohort of patients with newly diagnosed type 2 diabetes, only 51% had antihyperglycaemic medication initiated over a 2-year period following diagnosis. Older patients were significantly less likely to have been prescribed antihyperglycaemic medications. Elevated HbA1c was the strongest factor associated with initiating antihyperglycaemic medication in these patients.
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页数:7
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