Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes

A Mor, K Berencsi, E Svensson, J Rungby, J S Nielsen, S Friborg, I Brandslund, J S Christiansen, A Vaag, H Beck-Nielsen, H T Sørensen, R W Thomsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

AIM: To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.

METHODS: We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).

RESULTS: Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose-lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95% CI: 1.16-1.44) and 3.60 (95% CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95% CI: 1.05-1.38) and 2.08 (95% CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95% CI: 1.04-1.44) and 1.93 (95% CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95% CI: 1.10-1.42) and 1.94 (95% CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5%) [RR: 1.26 (95% CI: 1.20-1.32) and 2.86 (95% CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.

CONCLUSIONS: Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.

OriginalsprogEngelsk
TidsskriftDiabetic Medicine
Vol/bind32
Udgave nummer12
Sider (fra-til)1546-1554
ISSN0742-3071
DOI
StatusUdgivet - 1. jun. 2015

Fingeraftryk

Odds Ratio
Type 2 Diabetes Mellitus
Abdominal Obesity
Comorbidity
Hospital Outpatient Clinics
Denmark
General Practice
Weight Gain
Fasting
Exercise
Research
Pharmaceutical Preparations

Citer dette

Mor, A ; Berencsi, K ; Svensson, E ; Rungby, J ; Nielsen, J S ; Friborg, S ; Brandslund, I ; Christiansen, J S ; Vaag, A ; Beck-Nielsen, H ; Sørensen, H T ; Thomsen, R W. / Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes. I: Diabetic Medicine. 2015 ; Bind 32, Nr. 12. s. 1546-1554.
@article{04dcdd853f824ed0b9b1674602161078,
title = "Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes",
abstract = "AIM: To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.METHODS: We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).RESULTS: Among 1158 new Type 2 diabetes mellitus patients, 302 (26{\%}) did not receive glucose-lowering therapy within the first year, 723 (62{\%}) received monotherapy [685 (95{\%}) with metformin], and 133 (12{\%}) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95{\%} CI: 1.16-1.44) and 3.60 (95{\%} CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95{\%} CI: 1.05-1.38) and 2.08 (95{\%} CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95{\%} CI: 1.04-1.44) and 1.93 (95{\%} CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95{\%} CI: 1.10-1.42) and 1.94 (95{\%} CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5{\%}) [RR: 1.26 (95{\%} CI: 1.20-1.32) and 2.86 (95{\%} CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.CONCLUSIONS: Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.",
author = "A Mor and K Berencsi and E Svensson and J Rungby and Nielsen, {J S} and S Friborg and I Brandslund and Christiansen, {J S} and A Vaag and H Beck-Nielsen and S{\o}rensen, {H T} and Thomsen, {R W}",
note = "{\circledC} 2015 The Authors. Diabetic Medicine {\circledC} 2015 Diabetes UK.",
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doi = "10.1111/dme.12819",
language = "English",
volume = "32",
pages = "1546--1554",
journal = "Diabetic Medicine",
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Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes. / Mor, A; Berencsi, K; Svensson, E; Rungby, J; Nielsen, J S; Friborg, S; Brandslund, I; Christiansen, J S; Vaag, A; Beck-Nielsen, H; Sørensen, H T; Thomsen, R W.

I: Diabetic Medicine, Bind 32, Nr. 12, 01.06.2015, s. 1546-1554.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes

AU - Mor, A

AU - Berencsi, K

AU - Svensson, E

AU - Rungby, J

AU - Nielsen, J S

AU - Friborg, S

AU - Brandslund, I

AU - Christiansen, J S

AU - Vaag, A

AU - Beck-Nielsen, H

AU - Sørensen, H T

AU - Thomsen, R W

N1 - © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - AIM: To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.METHODS: We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).RESULTS: Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose-lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95% CI: 1.16-1.44) and 3.60 (95% CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95% CI: 1.05-1.38) and 2.08 (95% CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95% CI: 1.04-1.44) and 1.93 (95% CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95% CI: 1.10-1.42) and 1.94 (95% CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5%) [RR: 1.26 (95% CI: 1.20-1.32) and 2.86 (95% CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.CONCLUSIONS: Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.

AB - AIM: To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.METHODS: We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).RESULTS: Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose-lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95% CI: 1.16-1.44) and 3.60 (95% CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95% CI: 1.05-1.38) and 2.08 (95% CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95% CI: 1.04-1.44) and 1.93 (95% CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95% CI: 1.10-1.42) and 1.94 (95% CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5%) [RR: 1.26 (95% CI: 1.20-1.32) and 2.86 (95% CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.CONCLUSIONS: Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.

U2 - 10.1111/dme.12819

DO - 10.1111/dme.12819

M3 - Journal article

C2 - 26032247

VL - 32

SP - 1546

EP - 1554

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 12

ER -