PMID- 36134467 OWN - NLM STAT- MEDLINE DCOM- 20221215 LR - 20230415 IS - 1463-1326 (Electronic) IS - 1462-8902 (Print) IS - 1462-8902 (Linking) VI - 25 IP - 1 DP - 2023 Jan TI - Ethnic and socioeconomic disparities in initiation of second-line antidiabetic treatment for people with type 2 diabetes in England: A cross-sectional study. PG - 282-292 LID - 10.1111/dom.14874 [doi] AB - AIMS: To assess any disparities in the initiation of second-line antidiabetic treatments prescribed among people with type 2 diabetes mellitus (T2DM) in England according to ethnicity and social deprivation level. MATERIALS AND METHODS: This cross-sectional study used linked primary (Clinical Practice Research Datalink) and secondary care data (Hospital Episode Statistics), and the Index of Multiple Deprivation (IMD). We included people aged 18 years or older with T2DM who intensified to second-line oral antidiabetic medication between 2014 and 2020 to investigate disparities in second-line antidiabetic treatment prescribing (one of sulphonylureas [SUs], dipeptidyl peptidase-4 [DPP-4] inhibitors, or sodium-glucose cotransporter-2 [SGLT2] inhibitors, in combination with metformin) by ethnicity (White, South Asian, Black, mixed/other) and deprivation level (IMD quintiles). We report prescriptions of the alternative treatments by ethnicity and deprivation level according to predicted percentages derived from multivariable, multinomial logistic regression. RESULTS: Among 36 023 people, 85% were White, 10% South Asian, 4% Black and 1% mixed/other. After adjustment, the predicted percentages for SGLT2 inhibitor prescribing by ethnicity were 21% (95% confidence interval [CI] 19-23%), 20% (95% CI 18-22%), 19% (95% CI 16-22%) and 17% (95% CI 14-21%) among people with White, South Asian, Black, and mixed/other ethnicity, respectively. After adjustment, the predicted percentages for SGLT2 inhibitor prescribing by deprivation were 22% (95% CI 20-25%) and 19% (95% CI 17-21%) for the least deprived and the most deprived quintile, respectively. When stratifying by prevalent cardiovascular disease (CVD) status, we found lower predicted percentages of people with prevalent CVD prescribed SGLT2 inhibitors compared with people without prevalent CVD across all ethnicity groups and all levels of social deprivation. CONCLUSIONS: Among people with T2DM, there were no substantial differences by ethnicity or deprivation level in the percentage prescribed either SGLT2 inhibitors, DPP-4 inhibitors or SUs as second-line antidiabetic treatment. CI - (c) 2022 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. FAU - Bidulka, Patrick AU - Bidulka P AUID- ORCID: 0000-0001-7644-2030 AD - Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. FAU - Mathur, Rohini AU - Mathur R AD - Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. FAU - Lugo-Palacios, David G AU - Lugo-Palacios DG AD - Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. FAU - O'Neill, Stephen AU - O'Neill S AD - Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. FAU - Basu, Anirban AU - Basu A AD - The Comparative Health Outcomes, Policy & Economics (CHOICE) Institute, University of Washington School of Pharmacy, Seattle, Washington. FAU - Silverwood, Richard J AU - Silverwood RJ AD - Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, UK. FAU - Charlton, Paul AU - Charlton P AD - Patient Research Champion Team, National Institute for Health Research, Twickenham, UK. FAU - Briggs, Andrew AU - Briggs A AD - Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. FAU - Smeeth, Liam AU - Smeeth L AD - Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. FAU - Adler, Amanda I AU - Adler AI AD - Diabetes Trials Unit, The Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Headington, UK. FAU - Douglas, Ian J AU - Douglas IJ AD - Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. FAU - Khunti, Kamlesh AU - Khunti K AUID- ORCID: 0000-0003-2343-7099 AD - Diabetes Research Centre, University of Leicester, Leicester, UK. FAU - Grieve, Richard AU - Grieve R AD - Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. LA - eng GR - WT_/Wellcome Trust/United Kingdom PT - Journal Article DEP - 20221102 PL - England TA - Diabetes Obes Metab JT - Diabetes, obesity & metabolism JID - 100883645 RN - 0 (Hypoglycemic Agents) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Humans MH - Hypoglycemic Agents/therapeutic use MH - *Diabetes Mellitus, Type 2/drug therapy/epidemiology MH - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use MH - Cross-Sectional Studies MH - Socioeconomic Disparities in Health PMC - PMC10092566 OTO - NOTNLM OT - ethnicity OT - oral antidiabetics OT - pharmacoepidemiology OT - socioeconomic deprivation OT - type 2 diabetes COIS- All authors have completed an ICJME form. Patrick Bidulka, Stephen O'Neill, Anirban Basu, Richard Silverwood and Liam Smeeth have nothing to declare. Kamlesh Khunti has acted as a consultant, speaker or received grants for investigator-initiated studies for Astra Zeneca, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly and Merck Sharp & Dohme, Boehringer Ingelheim, Bayer, Berlin-Chemie AG / Menarini Group, Janssen and Napp. Rohini Mathur has received consulting fees from AMGEN. Paul Charlton sat on an NIHR HTA Commissioning Committee member until September 2021. Anirban Basu is an economic advisor on the DiRECT trial, with ongoing responsibility for economic analysis during the long-term follow-up phase, and has also acted as consultant to GlaxoSmithKline, Merck, Novo Nordisk and Boehringer Ingelheim in relation to their diabetes products. Amanda Adler receives salary from the NIHR BRC via the Oxford Centre for Diabetes, Endocrinology and Metabolism. Ian Douglas holds an unrestricted research grant from GSK and holds shares in GSK. Richard Grieve sits on the NIHR commissioning committee. EDAT- 2022/09/23 06:00 MHDA- 2022/12/15 06:00 PMCR- 2023/04/12 CRDT- 2022/09/22 04:15 PHST- 2022/09/06 00:00 [revised] PHST- 2022/07/13 00:00 [received] PHST- 2022/09/18 00:00 [accepted] PHST- 2022/09/23 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/09/22 04:15 [entrez] PHST- 2023/04/12 00:00 [pmc-release] AID - DOM14874 [pii] AID - 10.1111/dom.14874 [doi] PST - ppublish SO - Diabetes Obes Metab. 2023 Jan;25(1):282-292. doi: 10.1111/dom.14874. Epub 2022 Nov 2.