Glucose-Lowering Drug Trends and Glycemic Control

HealthDay News – For patients with type 2 diabetes, the use of glucose-lowering drugs changed from 2006 to 2013, but glycemic control has not changed, according to a study published online in Diabetes Care.

Kasia J. Lipska, MD, from the Yale School of Medicine in New Haven, Connecticut, and colleagues used claims data from 1.66 million privately insured and Medicare Advantage patients with type 2 diabetes to examine use of glucose-lowering medications, glycemic control, and the rate of severe hypoglycemia. The proportions were calculated overall and stratified by age and number of comorbidities.

The researchers observed an increase in use of metformin, dipeptidyl peptidase-4 inhibitors, and insulin, and a decline in use of sulfonylureas and thiazolidinediones, from 2006 to 2013 (all P <.001). There was a decline in the proportion of patients with hemoglobin A1C (HbA1C) <7% and an increase in the proportion with HbA1C ≥9% (both P <.001). There was variation in glycemic control based on age; in 2013, there was poor control among 23.3% of the youngest and 6.3% of the oldest patients. The overall severe hypoglycemia rate remained stable (1.3 per 100 person-years; P =.72).

“During the recent 8-year period, the use of glucose-lowering drugs has changed dramatically among patients with type 2 diabetes,” the authors wrote. “Overall glycemic control has not improved and remains poor among nearly a quarter of the youngest patients.”

Disclosures: Drs Lipska, Ross, and Krumholz are under contract for the Centers of Medicare & Medicaid Services to develop and maintain performance measures that are used for public reporting. Drs Ross and Krumholz have received research support through Yale University from Medtronic, Inc. and Johnson & Johnson (Janssen). Dr Krumholz also chairs a cardiac scientific advisory board for UnitedHealthcare, and Dr Ross receives research support from the Blue Cross Blue Shield Association. Dr Steinman is a consultant for Dr Inzucchi serves as consultant or research study committee member for Boehringer Ingelheim, Merck, AstraZeneca, Sanofi, Janssen, Daiichi Sankyo, and Novo Nordisk, and has served as a co-investigator on trials supported by Takeda. 


Lipska KJ, Yao X, Herrin J, et all. Trends in drug utilization, glycemic control, and rates of severe hypoglycemia, 2006-2013. Diabetes Care. 2016. doi:10.2337/dc16-0985.