National trends in anti-diabetic treatment in Taiwan, 2000-2009
Resource
J. Formos. Med. Assoc., 111(11), 617-624
Journal
Journal of the Formosan Medical Association
Journal Volume
111
Journal Issue
11
Pages
617-624
Date Issued
2012
Date
2012
Author(s)
Abstract
Background/Purpose: The impact of the introduction of newer anti-diabetic agents on the treatment pattern in the booming diabetic population remains unclear. We examined the patterns and temporal trends of anti-diabetic drug use in Taiwan, with particular emphasis on combination therapy.
Methods: We searched the Taiwan National Health Insurance Database during 2000-2009 to identify outpatient prescriptions of anti-diabetic drugs, including human insulins and insulin analogues, sulfonylureas, glinides, metformin, thiazolidinediones, alpha-glucosidase inhibitors, and dipeptidyl peptidase-4 inhibitors. Glucose-lowering treatments were classified according to pattern (oral agents only, insulins only, and oral agents and insulins combined) and a number of different classes of anti-diabetic drugs. Insulin therapy and combination therapy with two oral anti-diabetic drugs (OAD) were further classified according to individual drug combination patterns.
Results: Although metformin remained the mainstay of anti-diabetic treatment, patients receiving combination therapy of oral glucose-lowering agents, either with or without insulin, significantly increased, from approximately 40% in 2000 to 60% in 2009, particularly in relation to the newer agents, including glinides, alpha-glucosidase inhibitors, and long-acting insulin analogues. Use of sulfonylureas and thiazolidinediones decreased substantially. For insulin therapy, the most commonly prescribed drugs were premix insulin analogues and basal insulin analogues, accounting for one-third of total insulin prescriptions in 2009.
Conclusion: We found an increasing complexity of anti-diabetic therapy during the past decade in Taiwan. Further studies are needed to evaluate whether this treatment pattern will lead to improved clinical outcomes in terms of cost-effectiveness. Copyright (c) 2012, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
Subjects
diabetes mellitus
insulin pharmacotherapy
Taiwan
temporal trends
SDGs
Other Subjects
2,4 thiazolidinedione derivative; alpha glucosidase inhibitor; antidiabetic agent; dipeptidyl peptidase IV inhibitor; human insulin; insulin derivative; isophane insulin; long acting insulin; metformin; oral antidiabetic agent; pig insulin; short acting insulin; sulfonylurea; sulfonylurea derivative; article; diabetes mellitus; drug use; human; insulin treatment; national health insurance; outpatient care; prescription; Taiwan; trend study; Adult; Cost-Benefit Analysis; Diabetes Mellitus; Drug Costs; Humans; Hypoglycemic Agents; Morbidity; Registries; Taiwan
Type
journal article
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