Fifteen-year trends in diabetes drug management and control in French-speaking Switzerland.

Abstract

Objective: Drug management of type 2 diabetes (T2D) should comply with established guidelines. Still, little is known about how drug management of T2D in Switzerland has evolved over time. We aimed at assessing 15-year trends in antidiabetic drug prescription and its effectiveness in reducing fasting plasma glucose (FPG) levels.

Research design and methods: Data from the baseline (2003-2006) and three follow-ups (2009-2012, 2014-2017 and 2018-2021) of a population-based study conducted in Lausanne, Switzerland. Participants treated for T2D were included. At baseline and the follow-ups, participants had their antidiabetic drugs collected, together with their FPG and glycated haemoglobin (HbA₁c) levels.

Results: There were 274, 280, 268 and 195 participants treated for T2D at the baseline, first, second and third follow-ups, respectively, of whom 101 (36.9%), 103 (36.8%), 138 (51.5%) and 84 (43.1%) were controlled (FPG < 7 mmol/L). During the study period, the percentage of biguanides remained stable, the percentage of sulfonylureas and thiazolidinediones decreased, and the percentage of SGLT2 and DPP4 inhibitors increased, but no consistent association with T2D control was found. On bivariate and multivariable analysis, participants with newly diagnosed T2D had a higher likelihood of being controlled than participants with established T2D: odds ratio (95% CI) 3.39 (1.89-6.07), 5.41 (2.25-13.0) and 3.47 (1.45-8.31) for the first, second and third follow-ups on multivariable analysis, respectively.

Conclusions: Despite the prescription of novel antidiabetic drugs, half of participants treated for diabetes do not achieve adequate control in Switzerland. Participants with newly diagnosed diabetes achieve much better control than participants with established diabetes.