PMID- 31115873
OWN - NLM
STAT- MEDLINE
DCOM- 20191202
LR  - 20221207
IS  - 1179-6901 (Electronic)
IS  - 1174-5886 (Print)
IS  - 1174-5886 (Linking)
VI  - 19
IP  - 2
DP  - 2019 Jun
TI  - Timing of GLP-1 Receptor Agonist Initiation for Treatment of Type 2 Diabetes in 
      the UK.
PG  - 213-225
LID - 10.1007/s40268-019-0273-0 [doi]
AB  - INTRODUCTION: Patients with type 2 diabetes mellitus (T2DM) who fail to meet 
      glycaemic control are at increased risk of diabetes complications. For patients 
      who cannot maintain glycaemic control with oral medication, one recommended 
      option is to add an injectable glucagon-like peptide-1 receptor agonist (GLP-1 
      RA) to their treatment regimen. The purpose of this study was to examine time to 
      treatment intensification with GLP-1 RAs, including the duration of time that 
      patients did not maintain glycaemic control with oral medication. METHODS: This 
      was a medical record review conducted in the UK via a physician survey. Patients 
      eligible to have their records reviewed were required to be >/= 18 years of age, 
      have a confirmed T2DM diagnosis, and have initiated GLP-1 RA treatment for T2DM 
      in the past 6 months. All glycated haemoglobin (HbA1c) values within 5 years 
      prior to GLP-1 RA initiation were collected. RESULTS: A total of 113 physicians 
      contributed data for 1096 patients (mean age at the time of GLP-1 RA initiation 
      was 54.9 years, 55.4% were male, and 71.4% were White). Median time from T2DM 
      diagnosis to GLP-1 RA initiation was 6.1 years. Median consecutive time patients 
      taking oral regimens were not under glycaemic control (HbA1c > 7.0%) prior to 
      GLP-1 RA initiation was 13.5 months. Patients treated by general practitioners 
      (GPs) had a significantly longer duration of time with insufficient glycaemic 
      control prior to GLP-1 RA initiation compared with patients treated by diabetes 
      specialists (median time for specialists was 11.0 months vs. 17.0 months for GPs; 
      p = 0.038). CONCLUSIONS: Results suggest that treatment intensification is often 
      delayed despite consistently poor glycaemic control for more than 12 months, 
      contrary to treatment guideline recommendations. Findings from this study 
      highlight that some T2DM patients may benefit from more rapid treatment 
      intensification, which could improve glycaemic control and reduce the risk for 
      many short- and long-term health complications.
FAU - Boye, Kristina S
AU  - Boye KS
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
FAU - Stein, Dara
AU  - Stein D
AD  - Patient-Centered Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, 
      MD, 20814, USA.
FAU - Matza, Louis S
AU  - Matza LS
AD  - Patient-Centered Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, 
      MD, 20814, USA. louis.matza@evidera.com.
FAU - Jordan, Jessica
AU  - Jordan J
AD  - Patient-Centered Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, 
      MD, 20814, USA.
FAU - Yu, Ren
AU  - Yu R
AD  - Patient-Centered Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, 
      MD, 20814, USA.
FAU - Norrbacka, Kirsi
AU  - Norrbacka K
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
FAU - Hassan, Syed Wasi
AU  - Hassan SW
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
FAU - Garcia-Perez, Luis-Emilio
AU  - Garcia-Perez LE
AD  - Eli Lilly and Company, Indianapolis, IN, USA.
LA  - eng
GR  - EVA-19867/Eli Lilly and Company/
PT  - Journal Article
PL  - New Zealand
TA  - Drugs R D
JT  - Drugs in R&D
JID - 100883647
RN  - 0 (Blood Glucose)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Glucose/analysis/drug effects
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Female
MH  - Glucagon-Like Peptide-1 Receptor/*antagonists & inhibitors
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Physicians/statistics & numerical data
MH  - Practice Patterns, Physicians'/statistics & numerical data
MH  - Surveys and Questionnaires/statistics & numerical data
MH  - Time Factors
MH  - Time-to-Treatment
MH  - United Kingdom
PMC - PMC6544605
EDAT- 2019/05/23 06:00
MHDA- 2019/12/04 06:00
PMCR- 2019/05/21
CRDT- 2019/05/23 06:00
PHST- 2019/05/23 06:00 [pubmed]
PHST- 2019/12/04 06:00 [medline]
PHST- 2019/05/23 06:00 [entrez]
PHST- 2019/05/21 00:00 [pmc-release]
AID - 10.1007/s40268-019-0273-0 [pii]
AID - 273 [pii]
AID - 10.1007/s40268-019-0273-0 [doi]
PST - ppublish
SO  - Drugs R D. 2019 Jun;19(2):213-225. doi: 10.1007/s40268-019-0273-0.