Therapy of type 2 diabetes mellitus (T2DM) in the last 10 years has associated with the new drugs: glucagon-like peptide-1 receptor agonists (GLP-1ra), inhibitors of dipeptidylpeptidase type 4 (DPP-4i), inhibitors of sodium-glucose cotransporter type 2 (SGLT-2i).
To study modern approaches to therapy initiation in patients with T2DM the data from Moscow segment of Russian Federal Diabetes Register (MSRFDR) was analyzed.
The aim of the study was to analyze the structure of therapy initiation for newly diagnosed in 2018 T2DM based on MSRFDR.
Materials and methods: a cohort of patients with newly diagnosed in 2018 T2DM was formed from the MSFDR. Age, BMI, HbA1c, proportion of patients with HbA1c <7,0% were evaluated.
Results: MSRFDR contains data of 21.832 patients with newly diagnosed in 2018 T2DM; 597 patients (2,7%) of this group didn’t receive therapy, 19.586 patients (89,7%) were on oral glucose-lowering drugs (OGLDs) and/or GLP-1ra and 1.649 patients (7,6%) – on insulin therapy.
The better glycaemic control parameters were observed on Met and DPP-4i. Glycaemic control parameters were significantly worse in SU and SGLT-2i groups (p<0,05).
Patients on 2 oral glucose-lowering drugs (OGLDs) therapy were divided into 2 groups. Group 1 included patients receiving Met + SU/Glinides (3.704 pts), Group 2 - patients on DPP-4i, GLP-1ra or SGLT-2i therapy (1.031 pts). Glycaemic control parameters were better in Group 2 [НвА1с - 7,5% and 8,1% (p<0,05)].
Conclusion:
1. The proportion of patients with the level of HbA1c<7,0% in the first year of therapy was the highest on OGLD monotherapy (53,1%).
2. Glycaemic control parameters on 2 OGLDs therapy were better if patients used DPP-4i, GLP-1ra or SGLT-2i.