A study led by Professor Ji Linong of Peking University People's Hospital investigated the status quo and influencing factors of oral hypoglycemic drugs in the treatment of type 2 diabetes in China in the real world. The results were published online May 9 in the journal Diabetes.

This study included 9872 type 2 diabetes outpatients, all of whom had received oral hypoglycemic drugs (single drug or combination drug) for at least 3 months, and collected their current diabetes treatment regimen and relevant clinical data for analysis.

The results showed that the most commonly used oral hypoglycemic agents in China were insulin secreting agents (70.2%), including sulfonylureas (42.7%) and glienes (27.5%). This was followed by metformin (53.7%), -glucosidase inhibitors (35.9%), thiazolidinediones (17.2%), and DPP-4 inhibitors (0.8%). Two-drug combination was more common than monotherapy (45.4% and 35.8%, respectively), and three-drug combination was 17.0%. Patients treated with sulfonyl or gliene were more likely to change regimen frequently [OR1.7; 95%CI1.38-2.08; P<0.001].

'In China, many patients with diabetes change their treatment regimens because of unsatisfactory treatment outcomes, leading to changes in the overall use of oral hypoglycemic agents in the country,' the researchers wrote in their conclusion. The results of this study come from the real world and may be instructive for diabetes management in China.

In addition, the research observed the metformin monotherapy hypoglycemic events and replace the proportion of the drug are lower than other oral medications monotherapy, and promote the secrete agent to use insulin replacement therapy in patients with the frequency, poor blood sugar control and higher incidence of hypoglycemia events, this indicates that the frequency of the replacement therapy and negatively correlated with blood glucose control is at target situation.

Analysis of prescription data of hypoglycemic drugs in the United States

A study published in May in the journal DiabetesCare analysed national data on adult diabetes treatment prescriptions from RETAIL pharmacies in America between 2003 and 2012.

The results show that the market volume of hypoglycemic drugs in the United States is steadily rising. In 2012, the number of patients using hypoglycemic drugs in the United States reached 18.8 million, an increase of 42.9 percent compared with 2003. Metformin prescriptions reached 60.4 million, up 97 percent from 2003. The latest approved hypoglycemic drugs are gaining momentum, with the DPP-4 inhibitor Siglitine taking the largest market share, with 10.5 million prescriptions filled in 2012. Rosiglitazone was affected by a warning in 2011 to limit its use, and prescriptions dropped sharply in 2012 to less than 13,000.

The combined drug analysis showed that metformin was used in 44.9 percent of cases. About 33.4%~48.1% of sulfonylureas, DPP-4 inhibitors, thiazolidinedione and GLP-1 analogues were not used in combination with metformin. Although the guidelines recommend that metformin treatment should be maintained after the addition of other glucose-lowering drugs, the proportion of non-insulin hypoglycemic drugs not used with metformin is still up to 1/3 to 1/2, which needs further study.