Patterns of glycaemic control in patients with type 2 diabetes mellitus initiating second‐line therapy after metformin monotherapy: Retrospective data for 10 256 individuals from the United Kingdom and Germany

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2018-02, Vol.20 (2), p.389-399
• Main Authors: Khunti, Kamlesh, Godec, Thomas R., Medina, Jesús, Garcia‐Alvarez, Laura, Hiller, Josh, Gomes, Marilia B., Cid‐Ruzafa, Javier, Charbonnel, Bernard, Fenici, Peter, Hammar, Niklas, Hashigami, Kiyoshi, Kosiborod, Mikhail, Nicolucci, Antonio, Shestakova, Marina V., Ji, Linong, Pocock, Stuart
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cohort Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-Peptidase IV Inhibitors - adverse effects; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Drug Monitoring; Drug Resistance; Drug Therapy, Combination - adverse effects; Electronic Health Records; Female; Germany; glycaemic control; Glycated Hemoglobin - analysis; Humans; Hyperglycemia - prevention & control; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Longitudinal Studies; Male; Medicin och hälsovetenskap; Metformin - adverse effects; Metformin - therapeutic use; Middle Aged; observational study; Original; primary care; Retrospective Studies; Sulfonylurea Compounds - adverse effects; Sulfonylurea Compounds - therapeutic use; type 2 diabetes; United Kingdom; Young Adult
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.13083

Aim To investigate determinants of change in glycated haemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM) at 6 months after initiating uninterrupted second‐line glucose‐lowering therapies. Materials and Methods This cohort study utilized retrospective data from 10 256 patients with T2DM who initiated second‐line glucose‐lowering therapy (switch from or add‐on to metformin) between 2011 and 2014 in Germany and the UK. Effects of pre‐specified patient characteristics on 6‐month HbA1c changes were assessed using analysis of covariance. Results Patients had a mean (standard error [SE]) baseline HbA1c of 8.68% (0.02); 28.5% of patients discontinued metformin and switched to an alternative therapy and the remainder initiated add‐on therapy. Mean (SE) unadjusted 6‐month HbA1c change was −1.27% (0.02). When adjusted for baseline HbA1c, 6‐month changes depended markedly on the magnitude of the baseline HbA1c (HbA1c