한빛사논문
- 조회376
Beini Lyu1,2, Yingying Sang1, Elizabeth Selvin1,3, Alex R. Chang4, G. Caleb Alexander1,3, Cheli Melzer Cohen5, Josef Coresh1,3, Varda Shalev5,6, Gabriel Chodick5,6, Avraham Karasik6,7, Juan-Jesus Carrero8, Edouard L. Fu8,9, Yang Xu8,10, Morgan E. Grams1,11, and Jung-Im Shin1
1.Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore,MD
2.Institute for Global Health and Development, Peking University, Beijing, China
3.Department of Medicine, Johns Hopkins University,Baltimore,MD
4.Geisinger Kidney Health Research Institute, Danville, PA
5.Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
6.School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
7.Institute of Endocrinology, Chaim Sheba Medical Center, Ramat Gan, Israel
8.Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm,Sweden
9.Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brighamand Women’s Hospital and Harvard Medical School, Boston, MA
10.Peking University Clinical Research Institute,Peking University First Hospital, Beijing, China
11.Division of Precision Medicine, Department ofMedicine, New York University Grossman Schoolof Medicine, NY
Corresponding Author: Jung-Im Shin, MD, PhD
Abstract
Objective: To characterize and compare glucose-lowering medication use in type 2 diabetes in the U.S., Sweden, and Israel, including adoption of newer medications and prescribing patterns.
Research design and methods: We used data from the National Health and Nutrition Examination Survey (NHANES) from the U.S., the Stockholm CREAtinine Measurements (SCREAM) project from Sweden, and Maccabi Healthcare Services (Maccabi) from Israel. Specific pharmacotherapy for type 2 diabetes between 2007 and 2018 was examined.
Results: Use of glucose-lowering medications among patients with type 2 diabetes was substantially lower in NHANES and SCREAM than in Maccabi (66.0% in NHANES, 68.4% in SCREAM, and 88.1% in Maccabi in 2017-2018). Among patients who took at least one glucose-lowering medication in 2017-2018, metformin use was also lower in NHANES and SCREAM (74.1% in NHANES, 75.9% in SCREAM, and 92.6% in Maccabi) whereas sulfonylureas use was greater in NHANES (31.5% in NHANES, 16.0% in SCREAM, and 14.9% in Maccabi). Adoption of dipeptidyl peptidase 4 inhibitors and sodium-glucose cotransporter 2 inhibitors (SGLT2i) was slower in NHANES and SCREAM than in Maccabi. History of atherosclerotic cardiovascular disease, heart failure, reduced kidney function, or albuminuria was not consistently associated with greater use of SGLT2i or glucagon-like peptide 1 receptor agonists (GLP1RA) across the three countries.
Conclusions: There were substantial differences in real-world use of glucose-lowering medications across the U.S., Sweden, and Israel, with more optimal pharmacologic management in Israel. Variation in access to care and medication cost across countries may have contributed to these differences. SGLT2i and GLP1RA use in patients at high risk was limited in all three countries during this time period.
논문정보
- Research article
- 2022년 12월 (BRIC 등록일 2023-01-17)
- 국외 연구진
- 의약학 > 응용의학
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