György Jermendy, István Wittmann, László Nagy, Zoltán Kiss, György Rokszin, Zsolt Abonyi-Tóth, Lajos Katona, György Paragh, István Karádi, Béla Merkely: Persistence of initial oral antidiabetic treatment in patients with type 2 diabetes mellitus (Medical Science Monitor, 2012.02.01; 18(2): CR 72-77)
Background: Adequate persistence of oral antidiabetic treatment is highly important to achieve proper glycaemic control in patients with type 2 diabetes. The aim of the study was to evaluate the persistence of initial treatment with metformin and/or sulphonylureas in patients with type 2 diabetes.
Material/Methods: The study was performed among diabetic patients (n=256,384) who were newly prescribed oral antidiabetic drugs (metformin and/or sulphonylureas) between 2007 and 2009. For making comparison patients with newly prescribed statin or clopidogrel therapy (with and without percutaneous coronary intervention) were investigated. The database of the Hungarian National Health Insurance Fund Administration was used.
Results: The one year persistence of initial treatment with metformin, sulphonylureas or metformin/sulphonylurea combination was 47.7%, 45.4% and 55.8%, respectively which was significantly better than the persistence of statin therapy (26.3%) but worse than that of clopidogrel therapy in patients undergoing coronary intervention (73.2%). Within the sulphonylurea group there was a tendency of better persistence of treatment with the “modified-release” tablets at 12 months compared to the conventional sulphonylureas (47.8 vs. 42.2%). The persistence of therapy using metformin 1000 mg – 60 tablets was significantly better (60.4%) at 12 months than that of other forms of metformin therapy with lower doses and smaller boxes analyzed together (47.7%).
Conclusions: The persistence of initial treatment with metformin and/or sulphonylureas is far from optimal. Better diabetic care and continuous patient education should be encouraged to achieve higher persistence of oral antidiabetic treatment in patients with type 2 diabetes.