Characteristics of patients with type 2 diabetes mellitus newly treated with GLP-1 receptor agonists (CHADIG Study): a cross-sectional multicentre study in Spain. Issue 7 (26th July 2016)

• Record Type: Journal Article
• Authors: Conget, Ignacio; Mauricio, Dídac; Ortega, Rafael; Detournay, Bruno
• Other Names: author non-byline.; Muros Teresa author non-byline.; de la Cuesta Carmen author non-byline.; Mangas Miguel Ángel author non-byline.; Herrero Cristina Hernández author non-byline.; de Castro Hernandez Paloma author non-byline.; Peralta Fernando Gómez author non-byline.; García Manuel Miralles author non-byline.; Martinez Encarna author non-byline.; Cuatrecasas Guillem author non-byline.; Aguilera Eva author non-byline.; Gimenez Marga author non-byline.; Vinagre Irene author non-byline.; Anglada Jordi author non-byline.; Maraver Manuel Pérez author non-byline.; Manzanares Jose Maria author non-byline.; Catalina Pablo Fernández author non-byline.; Guerrero Diego Bellido author non-byline.; González Alfonso Soto author non-byline.; Casanueva Felipe author non-byline.; Masmiquel Lluis author non-byline.; Gómez Luis Alberto author non-byline.; García Honorato author non-byline.; Arguelles Iñaqui author non-byline.; Puig Juan Garcia author non-byline.; Sanfiel Miguel Angel Brito author non-byline.; Escalada Francisco Javier author non-byline.; Gaztambide Sonia author non-byline.; Hernández Mijares Antonio author non-byline.; Ampudia-Blasco Francisco Javier author non-byline.; Tréscoli Carlos author non-byline.; Torres Francisco Merino author non-byline.; de Teresa Parreño Luis author non-byline.;
• Is Part Of: BMJ open. Volume 6:Issue 7(2016)
• Publication Date: 2016-07-26
• Subjects: Type 2 diabetes mellitus -- GLP-1 receptor agonists -- Patients' characteristics -- Spain; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2015-010197
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Several glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1Ra) have been made recently available in Spain for type 2 diabetes mellitus (DM2) treatment. There are no published data on the clinical and sociodemographic profile of patients initiating treatment with GLP-1Ra in Spain. Our objective was to understand these patients' characteristics in a real-world clinical practice setting. Design: Cross-sectional observational study. Setting: Spanish specialist outpatient clinics. Participants: 403 adults with DM2 initiating GLP-1Ra treatment were included. Primary and secondary outcome measures: Sociodemographic and DM2-related clinical data, including treatment at and after GLP-1Ra initiation and comorbidities, were collected. Results: Evaluable patients (n=403; 50.9% female) were included (July 2013 to March 2014) at 24 centres by 53 specialists (47 endocrinology, 6 internal medicine), with the following profile (value±SD): age (58.3±10.4 years), diabetes duration (9.9±7 years), body mass index (BMI; 36.2±5.5) and glycated haemoglobin (HbA1c; 8.4±1.4%); 14% had HbA1c≤7%. Previous antidiabetic treatment: 53.8% only oral antidiabetic drugs (OADs), 5.2% insulin and 40% insulin and OAD; of those receiving OAD, 35% single drug, 38.2% 2 drugs and 24% 3 drugs. Concomitant to GLP-1Ra, 55.3% were only on OAD, 36.2% on insulin and OAD, and 7.2% only on insulin. Of those receiving OAD, the GLP-1Ra was mainly associated with 1 drug (65%) or 2 drugs (31.8%). GLP-1Ra are frequently added to existing antidiabetic drugs, with dipeptidyl peptidase-4 inhibitors being the OAD most frequently switched (45% receiving 1 before starting GLP-1Ra, only 2.7% receiving it concomitantly). Conclusions: In Spain, GLP-1Ra therapy is usually started in combination with OADs or OADs and insulin. These drugs are used in relatively young patients often not reaching therapeutic goals with other treatment combinations, roughly a decade after diagnosis and with a relatively high BMI. The latter could be explained by Spanish regional payers limiting reimbursed prescription to patients with a minimum BMI threshold (>30 in most regions, >35 in some).