胰高血糖素样肽-1受体激动剂类药物(GLP-1 RA)在启动注射治疗患者中的应用

Authors

John E. Anderson MD

GLP-1 RAs are a major class of antihyperglycemic agent. However knowledge of contemporary prescribing patterns in PC is poor. We used Diabetes FORWARD (DF) a large PC practice-based research network spread throughout North America to examine GLP-1 RA use.

Data from electronic health records was collected from 56 sites for March-September 2012. Eligible patients were aged ≥18 y; had type 2 diabetes mellitus (T2DM); initiated injectable treatment within the last year; were treated predominantly in PC or an associated endocrinologist’s office; and had an A1C measurement at injectable treatment initiation (≤6 weeks pre-initiation).

Of 935 patients enrolled in DF 208 were eligible for this analysis. In line with currently enrolled sites 83.8% of which were PC practices most patients lived in the Southern US (66.7%); only a minority initiated a GLP-1 RA (Fig A). Patients initiating GLP-1 RA alone or in combination were younger than those initiating insulin alone (55.0 53.2 and 58.9 y) with higher BMI (Fig B) and a higher proportion of private insurance (64.7% 55.6% and 40.6%). T2DM duration was lower in GLP-1 RA or combination therapy patients (Fig C). A1C was highest in patients initiating combination therapy followed by insulin alone and GLP-1 RAs (Fig D).

At this early stage of compiling DF data few patients prescribed injectables received GLP-1 RAs. GLP-1 RA prescribing was more common in patients with higher BMI and private insurance.

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