With various hypoglycemic agents (HAs) now available, the optimal treatment order and combination therapies for type 2 diabetes patients remains debatable. In this study, we aimed to clarify the current treatment patterns of Japanese type 2 diabetes patients using glucagon-like peptide-1 receptor agonist (GLP-1RA).
Data on patients using GLP-1RA was retrospectively collected from the Jikei University Hospital electronic health record system using the Standardized Structured Medical record Information eXchange (SS-MIX) from January 2017 to September 2018. Descriptive analysis to compare patient demographics and other HA use among patients divided by the timing of GLP-1RA administration was performed.
In this study, 145 patients on GLP-1RA were identified from over 6,000 type 2 diabetes patients. Patients on GLP-1RA demonstrated a mean age of 64.5 years, mean HbA1c of 8.4% with a mean duration of diabetes history of 7.3 years. Among these patients, 71 patients received liraglutide (48.9%) and 66 received dulaglutide (47.5%). GLP-1RA was prescribed as first line therapy in 1.4%, second-line in 17.3%, third-line in 31.7%, fourth-line in 27.3%, fifth-line in 15.8%, and sixth-line in 6.5%.Overall, patients with a history of cardiovascular disease or heart failure (p=0.026), age older than 75 years (p=0.015),and those with renal dysfunction (p=0.027) received GLP-1RA at a significantly earlier timing.
In our institution, GLP-1RA was most frequently prescribed as third or fourth-line HA especially for those with known cardiovascular disease, higher age and renal dysfunction.