PMID- 36295543 OWN - NLM STAT- MEDLINE DCOM- 20221028 LR - 20230308 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 58 IP - 10 DP - 2022 Oct 1 TI - Changing Patterns of Antihyperglycaemic Treatment among Patients with Type 2 Diabetes in Hungary between 2015 and 2020-Nationwide Data from a Register-Based Analysis. LID - 10.3390/medicina58101382 [doi] LID - 1382 AB - Background and objectives: In the last couple of years, pharmacological management of patients with type 2 diabetes mellitus (T2DM) have been markedly renewed. The aim of this study was to analyse the changes in prescribing patterns of antidiabetic drugs for treating patients with T2DM in Hungary between 2015 and 2020. Material and Methods: In this retrospective, nationwide analysis, we used the central database of the National Health Insurance Fund. We present annual numbers and their proportion of T2DM patients with different treatment regimens. Results: In the period of 2015-2020, the number of incident cases decreased from 60,049 to 29,865, while prevalent cases increased from 682,274 to 752,367. Patients with metformin (MET) monotherapy had the highest prevalence (31% in 2020). Prevalence of insulin (INS) monotherapy continuously but slightly decreased from 29% to 27% while that of sulfonylurea (SU) monotherapy markedly decreased from 37% to 20%. Dipeptidyl peptidase (DPP-4) inhibitors remained popular in 2020 as monotherapy (5%), in dual combination with MET (12%) and in triple combination with MET and SU (5%). The prevalence of patients with sodium-glucose co-transporter-2 (SGLT-2) inhibitors increased from 1% to 4% in monotherapy, from <1% to 6% in dual combination with MET, and from <1% to 2% in triple oral combination with MET and SU or DPP-4-inhibitors. The prevalence of patients using glucagon-like peptide-1 receptor agonists (GLP-1-RAs) also increased but remained around 1-2% both in monotherapy and combinations. For initiating antihyperglycaemic treatment, MET monotherapy was the most frequently used regime in 2020 (50%), followed by monotherapy with SUs (16%) or INS (10%). After initial MET monotherapy, the incidence rates of patients with add-on GLP-1-RAs (2%, 3%, and 4%) and those of add-on SGLT-2 inhibitors (4%, 6%, and 8%) slowly increased in the subsequent 24, 48, and 72 months, respectively. Conclusions: In the period of 2015-2020, we documented important changes in trends of antihyperglycaemic therapeutic patterns in patients with T2DM which followed the new scientific recommendations but remained below our expectations regarding timing and magnitude. More efforts are warranted to implement new agents with cardiovascular/renal benefits into therapeutic management in time, in a much larger proportion of T2DM population, and without delay. FAU - Jermendy, Gyorgy AU - Jermendy G AUID- ORCID: 0000-0001-5596-7831 AD - Department of Internal Medicine, Bajcsy-Zsilinszky Teaching Hospital and Outpatient Clinic, Maglodi ut 89-91, 1106 Budapest, Hungary. FAU - Kiss, Zoltan AU - Kiss Z AD - Nephrology-Diabetes Center, 2nd Department of Internal Medicine, Faculty of Medicine, University of Pecs, Pacsirta ut 1, 7624 Pecs, Hungary. FAU - Rokszin, Gyorgy AU - Rokszin G AD - RxTarget Ltd., Bacso Nandor utca 10, 5000 Szolnok, Hungary. FAU - Abonyi-Toth, Zsolt AU - Abonyi-Toth Z AD - RxTarget Ltd., Bacso Nandor utca 10, 5000 Szolnok, Hungary. FAU - Lengyel, Csaba AU - Lengyel C AD - Department of Internal Medicine, Faculty of Medicine, University of Szeged, Kalvaria sgt. 57, 6725 Szeged, Hungary. FAU - Kempler, Peter AU - Kempler P AD - Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Koranyi Sandor ut 2, 1082 Budapest, Hungary. FAU - Wittmann, Istvan AU - Wittmann I AUID- ORCID: 0000-0001-5163-5733 AD - Nephrology-Diabetes Center, 2nd Department of Internal Medicine, Faculty of Medicine, University of Pecs, Pacsirta ut 1, 7624 Pecs, Hungary. LA - eng PT - Journal Article DEP - 20221001 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 RN - 0 (Hypoglycemic Agents) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - 0 (Dipeptidyl-Peptidase IV Inhibitors) RN - 0 (Glucagon-Like Peptide-1 Receptor) RN - 0 (Blood Glucose) RN - 0 (Sulfonylurea Compounds) RN - 9100L32L2N (Metformin) RN - 0 (Insulin) RN - 89750-14-1 (Glucagon-Like Peptide 1) RN - EC 3.4.14.- (Dipeptidyl-Peptidases and Tripeptidyl-Peptidases) RN - 0 (Symporters) RN - 9NEZ333N27 (Sodium) SB - IM MH - Humans MH - Hypoglycemic Agents MH - *Diabetes Mellitus, Type 2/drug therapy/epidemiology MH - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use MH - *Dipeptidyl-Peptidase IV Inhibitors/therapeutic use MH - Glucagon-Like Peptide-1 Receptor/therapeutic use MH - Retrospective Studies MH - Hungary/epidemiology MH - Blood Glucose MH - Sulfonylurea Compounds/therapeutic use MH - *Metformin/therapeutic use MH - Insulin/therapeutic use MH - Glucagon-Like Peptide 1/therapeutic use MH - Dipeptidyl-Peptidases and Tripeptidyl-Peptidases/therapeutic use MH - *Symporters/therapeutic use MH - Sodium PMC - PMC9612371 OTO - NOTNLM OT - DPP-4 inhibitors OT - GLP-1 receptor agonists OT - SGLT-2 inhibitors OT - antihyperglycaemic drugs OT - diabetes therapy OT - insulin treatment OT - metformin OT - register-based analysis OT - sulfonylurea OT - type 2 diabetes COIS- Zoltan Kiss is employed by MSD Pharma Hungary Ltd. However, this provides no relevant conflict of interest for the current research. All other authors declare no conflict of interest. EDAT- 2022/10/28 06:00 MHDA- 2022/10/29 06:00 PMCR- 2022/10/01 CRDT- 2022/10/27 01:37 PHST- 2022/08/09 00:00 [received] PHST- 2022/09/17 00:00 [revised] PHST- 2022/09/26 00:00 [accepted] PHST- 2022/10/27 01:37 [entrez] PHST- 2022/10/28 06:00 [pubmed] PHST- 2022/10/29 06:00 [medline] PHST- 2022/10/01 00:00 [pmc-release] AID - medicina58101382 [pii] AID - medicina-58-01382 [pii] AID - 10.3390/medicina58101382 [doi] PST - epublish SO - Medicina (Kaunas). 2022 Oct 1;58(10):1382. doi: 10.3390/medicina58101382.