HealthDay News – Trends indicate a reduction in glyburide and thiazolidinedione prescriptions and increases in gliclazide and dipeptidyl peptidase-4 (DPP-4) inhibitor prescriptions among older adults with diabetes and chronic kidney disease (CKD), according to a study published online March 4 in Diabetes, Obesity and Metabolism.

Kristin K. Clemens, MD, from Western University in London, Canada, and colleagues conducted a population-based study involving 144 252 older adults with diabetes and CKD. The proportion of treated and newly treated patients prescribed insulin, sulphonylureas, alpha glucosidase inhibitors, metformin, thiazolidinediones, meglitinides, and DPP-4 inhibitors was examined in each study quarter (from April 1, 2004, through March 31, 2013). Prescription trends were further examined by stage of CKD.

Researchers found that the predominant therapy prescribed was metformin (prescribed to 56.1% of treated patients). Decreases were seen in glyburide (glibenclamide) and thiazolidinedione prescriptions, while there were increases in gliclazide and DPP-4 inhibitor prescriptions. Glyburide was prescribed for up to 48.6% of patients with stage 3a to 5 CKD or on chronic dialysis, while metformin was prescribed for up to 27.6% of those with stage 4 or 5 disease or on chronic dialysis.


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“In patients with [CKD]. there were trends towards safer antihyperglycemic medication prescribing,” the authors wrote. “A considerable number of patients, however, continue to receive medications that should be avoided.”

Disclosures: Two authors disclosed financial ties to the pharmaceutical industry.

Reference

Clemens KK, Liu K, Shariff S, Schernthaner G, Tangri N, Garg AX. Secular trends in antihyperglycemic medication prescriptions in older adults with diabetes and chronic kidney disease: 2004—2013. Diabetes Obes Metab. doi: 10.1111/dom.12658.