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Diabetes management and treatment approaches outside of North America and West Europe in 2006 and 2015

  • Maryam TabeshEmail author
  • Dianna J. Magliano
  • Stephanie K. Tanamas
  • Filip Surmont
  • Silver Bahendeka
  • Chern-En Chiang
  • Jorge F. Elgart
  • Juan J. Gagliardino
  • Sanjay Kalra
  • Satheesh Krishnamoorthy
  • Andrea Luk
  • Hiroshi Maegawa
  • Ayesha A. Motala
  • Fraser Pirie
  • Ambady Ramachandran
  • Khaled Tayeb
  • Olga Vikulova
  • Jencia Wong
  • Jonathan E. Shaw
Original Article
  • 57 Downloads

Abstract

Aims

The impact of introducing new classes of glucose-lowering medication (GLM) on diabetes management remains unclear, especially outside North America and Western Europe. Therefore, we aimed to analyse trends in glycaemic control and the usage of new and old GLMs in people with type 2 diabetes from 2006 to 2015.

Methods

Summary data from clinical services from nine countries outside North America and Western Europe were collected and pooled for statistical analysis. Each site summarized individual-level data from out-patient medical records for 2006 and 2015. Data included: demographics; HbA1c and fasting plasma glucose levels; and the proportions of patients taking GLM as monotherapy, combination therapy and/or insulin.

Results

Between 2006 and 2015, glycaemic control remained stable, although body mass index and duration of diabetes increased in most sites. The proportion of people on GLM increased, and the therapeutic regimens became more complex. There were increases in the use of insulin and triple therapy in most sites, while monotherapy, particularly in relation to sulphonylureas, decreased. Despite the introduction of new GLMs, such as DPP-4 inhibitors, insulin use increased over time.

Conclusions

There was no clear evidence that the use of new classes of GLMs was associated with improvements in glycaemic control or reduced the reliance on insulin. These findings were consistent across a range of economic and geographic settings.

Keywords

Diabetes mellitus Glycated haemoglobin Disease management Therapeutics Hypoglycaemic agents 

Notes

Acknowledgements

This study is funded by AstraZeneca. MT is supported by a Monash University Postgraduate Research Scholarship and a Baker IDI Bright Sparks Scholarship, Australia. JES and DJM are supported by National Health and Medical Research Council Senior Research Fellowships, Australia. This work is partially supported by the Victorian OIS program.

Compliance with ethical standards

Conflict of interest

This study was supported by AstraZeneca.

Human and animal rights disclosure

The study was approved by the Monash University Human Research Ethics Committee (number 1441), and the Alfred Ethics Committee (number 64/15) in Australia and in some of the sites, as required by local guidelines.

Informed consent

For this type of study, informed consent is not required.

Supplementary material

592_2018_1284_MOESM1_ESM.docx (37 kb)
Supplementary material 1 (DOCX 37 KB)

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  • Maryam Tabesh
    • 1
    • 2
    Email author
  • Dianna J. Magliano
    • 1
    • 2
  • Stephanie K. Tanamas
    • 1
  • Filip Surmont
    • 3
  • Silver Bahendeka
    • 4
  • Chern-En Chiang
    • 5
  • Jorge F. Elgart
    • 6
  • Juan J. Gagliardino
    • 6
  • Sanjay Kalra
    • 7
  • Satheesh Krishnamoorthy
    • 8
  • Andrea Luk
    • 9
  • Hiroshi Maegawa
    • 10
  • Ayesha A. Motala
    • 11
  • Fraser Pirie
    • 11
  • Ambady Ramachandran
    • 8
  • Khaled Tayeb
    • 12
  • Olga Vikulova
    • 13
  • Jencia Wong
    • 14
  • Jonathan E. Shaw
    • 1
    • 2
  1. 1.Baker Heart and Diabetes InstituteMelbourneAustralia
  2. 2.Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneAustralia
  3. 3.AstraZenecaLondonUK
  4. 4.MKPGMS-Uganda Martyrs University and St. Francis Hospital NsambyaKampalaUganda
  5. 5.General Clinical Research CenterTaipei Veterans General HospitalTaipeiTaiwan
  6. 6.Facultad de Ciencias Médicas UNLPCENEXA, Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET)La PlataArgentina
  7. 7.Bharti Research Institute of Diabetes and EndocrinologyBharti HospitalKarnalIndia
  8. 8.Dr A Ramachandran’s Diabetes HospitalsChennaiIndia
  9. 9.Department of Medicine and TherapeuticsPrince of Wales HospitalSha TinChina
  10. 10.Shiga University of Medical ScienceShigaJapan
  11. 11.Department of Diabetes and EndocrinologyUniversity of KwaZulu NatalDurbanSouth Africa
  12. 12.Diabetes Center at Al-Noor Specialist HospitalMeccaSaudi Arabia
  13. 13.FGBU “Endocrinology Research Center” Ministry of HealthMoscowRussia
  14. 14.Royal Prince Alfred Hospital Diabetes CentreUniversity of SydneySydneyAustralia

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