Sulfonylurea Prescribing Patterns After the Introduction of DPP-4 Inhibitors and GLP-1 Receptor Agonists

Payk, Stephanie L.; Drew, Richard H.; Smith, Jennifer D.; Jiroutek, Michael R.; Holland, Melissa A.

doi:10.1016/j.clinthera.2015.04.011

Cited by 7 publications

(17 citation statements)

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“…4 Recent surveys have indicated that tight glycaemic control may be relatively common in patients who are unlikely to benefit and who may be at increased risk of harm. 11,17,18 Treatment with insulin and sulphonylureas, commonly used in contemporary practice, 19 may be particularly hazardous in this situation, whereas metformin is recommended for firstline treatment because of its relatively favourable safety profile. 15,16 It has been estimated that between 20% and 60% of older patients with diabetes in the USA may be overtreated.…”

Section: Introductionmentioning

confidence: 99%

“…The FDS2 recruited participants at a time when few were receiving the novel classes of glucose-lowering therapy that may be better tolerated in older patients, although sulphonylureas and insulin remain important therapeutic tools at the present time 19. Confounding by indication is an important alternative explanation for these associations and we have no information on the reasons behind specific prescriptions.…”

mentioning

confidence: 99%

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Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Bruce

Davis

2018

Diabetes Obesity Metabolism

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Bruce

Davis

2018

Diabetes Obesity Metabolism

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“…Sulphonylurea therapy continues to be commonly prescribed in monotherapy or in combination with other OAMs, and basal insulin continues to be recommended as first‐line injectable therapy to people with T2D . Despite the importance of avoiding hypoglycaemia in older patients, these therapies are still considered reasonably safe options in this population as reflected by studies examining treatment patterns . Sulfonylurea exerts its glucose‐lowering action primarily through stimulation of insulin secretion .…”

Section: Introductionmentioning

confidence: 99%

“…7,16 Despite the importance of avoiding hypoglycaemia in older patients, 6,9 these therapies are still considered reasonably safe options in this population as reflected by studies examining treatment patterns. [19][20][21] Sulfonylurea exerts its glucoselowering action primarily through stimulation of insulin secretion. 22 This action does not depend on blood glucose levels and thus may cause excessive insulin secretion and trigger hypoglycaemia.…”

Section: Introductionmentioning

confidence: 99%

Glycaemic outcomes of an Individualized treatMent aPproach for oldER vulnerable patIents: A randomized, controlled stUdy in type 2 diabetes Mellitus (IMPERIUM)

Heller

Pratley

Sinclair

et al. 2017

Diabetes Obesity Metabolism

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AimsTo compare the glycaemic outcomes of 2 glucose‐lowering treatment strategies in vulnerable (moderately ill and/or frail) patients aged ≥65 years with type 2 diabetes whose individual HbA1c targets were not met with diet/exercise and/or oral anti‐hyperglycaemic medications (OAMs).MethodsThe primary endpoint of this study was a composite of achieving/maintaining individualized HbA1c targets without “clinically significant” hypoglycaemia (severe hypoglycaemia or repeated hypoglycaemia causing interruption of patients’ activities or blood glucose <54 mg/dL). Strategy‐A comprised glucose‐dependent therapies (n = 99) with a non‐sulphonylurea OAM and a glucagon‐like peptide‐1 receptor agonist as the first injectable. Strategy‐B comprised non‐glucose‐dependent therapies (n = 93) with sulphonylurea as the preferred OAM and insulin glargine as the first injectable.ResultsThere was no significant difference between Strategy‐A and Strategy‐B in percentages of patients achieving the primary endpoint (64.5% vs 54.9%; P = .190). Mean incidences (A vs B) of total (10.2% vs 53.8%), documented symptomatic (5.1% vs 36.6%), and asymptomatic (8.2% vs 32.3%) hypoglycaemia were lower for Strategy‐A (P < .001 each). Proportions of patients achieving/maintaining HbA1c target (A, 63.3% vs B, 55.9%) were similar.ConclusionSimilar proportions of older, vulnerable aged ≥65 years patients with type 2 diabetes achieved/maintained glycaemic treatment goals without clinically significant hypoglycaemia with Strategies A or B. However, Strategy‐A resulted in lower risk of total, documented symptomatic, and asymptomatic hypoglycaemia. These results identify an approach of potential clinical benefit in this age group and will inform future clinical research in older patients with type 2 diabetes.

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“…A pesar de ello las sulfonilureas se constituyen en un grupo de medicamentos ampliamente utilizados, aun con la introducción de medicamentos como los inhibidores de dipeptidil-peptidasa-IV y los análogos del péptido similar al glucagón tipo 1 2 . Estos continúan siendo los antidiabéticos más prescritos en algunas regiones del mundo 3 , permaneciendo junto con la metformina como el tratamiento farmacológico más usado 4 .…”

Section: Introductionunclassified

Evaluación de la prescripción de glibenclamida en diabéticos tipo 2

Castro¹,

Estrada

Goez

2017

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RESUMENIntroducción: Las sulfonilureas permanecen junto con la metformina como el tratamiento farmacológico más usado para los pacientes diabéticos tipo 2, y continúan siendo los antidiabéticos más prescritos en algunas regiones del mundo. Objetivo: Evaluar la prescripción de glibenclamida en aspectos relacionados a contraindicaciones, dosificación, y prevención de efectos adversos, en el tratamiento de los pacientes diabéticos tipo 2 que acuden a una institución de salud de baja complejidad en Cartagena de Indias, Colombia. Metodología: Estudio descriptivo con enfoque desde la fármaco-epidemiología dirigido específicamente al campo de los estudios de utilización de medicamentos, basado en los datos recogidos mediante revisión de historias clínicas de 331 pacientes diabéticos tipo 2, mayores de 18 años en un centro de atención primaria en salud de la ciudad de Cartagena de Indias entre los años 2013 y 2014. Se estudiaron variables demográficas, clínicas y paraclínicas, el esquema terapéutico y la calidad de la prescripción. La información se analizó usando estadística descriptiva. Resultados: 57 % (189) de los pacientes utilizaron glibenclamida siendo un 59.3 % (153) prescrito de manera inadecuada, 45.5% (86) tenían alguna contraindicación para el empleo del medicamento. En 1 % de los pacientes de la muestra se prescribió sobrepasando el rango de dosis terapéutica Conclusiones: La calidad de la prescripción de la glibenclamida fue inadecuada en una proporción importante de pacientes, se hace necesario implementar estrategias educacionales que capaciten al personal médico para una correcta utilización de los fármacos antidiabéticos. La glibenclamida comparada con otras sulfonilureas de segunda generación nos brinda más desventajas que ventajas.Palabras Clave: Diabetes Mellitus Tipo 2, glibenclamida, contraindicaciones, tasa de filtración glomerular, prescripciones de medicamentos, farmacoepidemiología. ABSTRACTIntroduction: Sulfonylureas remain with metformin as the most used drug treatment for type 2 diabetic patients and remain the most prescribed anti-diabetic in some regions of the world. Target: Evaluate prescribing glyburide in aspects related to contraindications, dosage, and prevention of adverse effects, in the treatment of type 2 diabetic patients attending a health institution low complexity in Cartagena de Indias, Colombia. Methodology: Descriptive study with approach from the pharmaco-epidemiology specifically directed to the field of studies of drug use, based on the data collected through review of medical records of 331 type 2 diabetic patients over 18 years in a primary

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Sulfonylurea Prescribing Patterns After the Introduction of DPP-4 Inhibitors and GLP-1 Receptor Agonists

Cited by 7 publications

References 5 publications

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Glycaemic outcomes of an Individualized treatMent aPproach for oldER vulnerable patIents: A randomized, controlled stUdy in type 2 diabetes Mellitus (IMPERIUM)

Evaluación de la prescripción de glibenclamida en diabéticos tipo 2

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