Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar 7:12:1.
doi: 10.1186/1472-6823-12-1.

Factors associated with initiation of antihyperglycaemic medication in UK patients with newly diagnosed type 2 diabetes

Alan J Sinclair  1 , Charles M Alexander, Michael J Davies, Changgeng Zhao, Panagiotis Mavros
Affiliations

Factors associated with initiation of antihyperglycaemic medication in UK patients with newly diagnosed type 2 diabetes

Alan J Sinclair et al. BMC Endocr Disord. .

Abstract

Aim: To assess the factors associated with antihyperglycaemic medication initiation in UK patients with newly diagnosed type 2 diabetes.

Methods: In a retrospective cohort study, patients with newly diagnosed type 2 diabetes were identified during the index period of 2003-2005. Eligible patients were ≥ 30 years old at the date of the first observed diabetes diagnosis (referred to as index date) and had at least 2 years of follow-up medical history (N = 9,158). Initiation of antihyperglycaemic medication (i.e., treatment) was assessed in the 2-year period following the index date. Adjusted Cox regression models were used to examine the association between time to medication initiation and patient age and other factors.

Results: Mean (SD) HbA1c at diagnosis was 8.1% (2.3). Overall, 51% of patients initiated antihyperglycaemic medication within 2 years (65%, 55%, 46% and 40% for patients in the 30- < 45, 45- < 65, 65- < 75, 75+ age groups, respectively). Among the treated patients, median (25th, 75th percentile) time to treatment initiation was 63 (8, 257) days. Of the patients with HbA1c ≥ 7.5% at diagnosis, 87% initiated treatment within 2 years. These patients with a higher HbA1c also had shorter time to treatment initiation (adjusted hazard ratio (HR) = 2.44 [95% confidence interval (CI): 1.61, 3.70]; p < 0.0001). Increasing age (in years) was negatively associated with time to treatment initiation (HR = 0.98 [95% CI: 0.97, 0.99]; p < 0.001). Factors significantly associated with shorter time to treatment initiation included female gender and use of cardiovascular medications at baseline or initiated during follow up.

Conclusions: In this UK cohort of patients with newly diagnosed type 2 diabetes, only 51% had antihyperglycaemic medication initiated over a 2-year period following diagnosis. Older patients were significantly less likely to have been prescribed antihyperglycaemic medications. Elevated HbA1c was the strongest factor associated with initiating antihyperglycaemic medication in these patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier curves for time to initiation of antihyperglycaemic therapy after diagnosis of type 2 diabetes by age group.
Figure 2
Figure 2
Proportion of patients untreated with antihyperglycaemic medication after the 2-year follow-up period by age group and last available HbA1c value.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Collaborating Centre for Chronic Conditions. Type 2 diabetes: National clinical guideline for management in primary and secondary care (update) London: Royal College of Physicians; 2008. - PubMed
    1. American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care. 2011;34(1):S11–S61. - PMC - PubMed
    1. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R. et al.Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2009;52:17–30. doi: 10.1007/s00125-008-1157-y. - DOI - PubMed
    1. Olivarius N, Andreasen AH, Siersma V, Richelsen B, Beck-Nielsen H. Changes in patient weight and the impact of antidiabetic therapy during the first 5 years after diagnosis of diabetes mellitus. Diabetologia. 2006;49:2058–2067. doi: 10.1007/s00125-006-0328-y. - DOI - PubMed
    1. Olivarius N, Beck-Nielsen H, Andreasen AH, Horder M, Pedersen PA. Randomised controlled trial of structured personal care of type 2 diabetes mellitus. BMJ. 2001;323:970–975. doi: 10.1136/bmj.323.7319.970. - DOI - PMC - PubMed

LinkOut - more resources