Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape
ABSTRACT Aims In patients with new onset type 2 diabetes, this study aimed to analyze glucose‐lowering medication use patterns between 2014 and 2022. Materials and Methods This retrospective study included adults with incident type 2 diabetes in the University of California Health System between 201...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Journal of Diabetes |
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| Online Access: | https://doi.org/10.1111/1753-0407.70108 |
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| author | William Hou Katherine R. Tuttle Weining Shen Andrew Reikes Jonathan H. Watanabe |
| author_facet | William Hou Katherine R. Tuttle Weining Shen Andrew Reikes Jonathan H. Watanabe |
| author_sort | William Hou |
| collection | DOAJ |
| description | ABSTRACT Aims In patients with new onset type 2 diabetes, this study aimed to analyze glucose‐lowering medication use patterns between 2014 and 2022. Materials and Methods This retrospective study included adults with incident type 2 diabetes in the University of California Health System between 2014 and 2022. We determined medications used within 1 year of diagnosis and evaluated statistical evidence of use pattern changes via Mann–Kendall trend tests. Four categories of high‐risk patients requiring cardio‐kidney‐metabolic protection were also evaluated in stratified analyses based on 2024 ADA guidelines. Results Of 40 150 patients with incident type 2 diabetes, 38.5% initiated glucose‐lowering medication within 1 year. Metformin remained the most used medication from 2014 to 2022. From 2014 to 2022, usage of GLP‐1 receptor agonists and SGLT‐2 inhibitors increased exponentially. GLP‐1 receptor agonist use increased from below 2.5%–21%. While SGLT‐2 inhibitor use increased from less than 2.5%–14%. This growth coincided with a decline in sulfonylurea usage. Among high‐risk, insulin was most prevalent in those with heart failure or chronic kidney disease. However, usage of insulin declined overall in all groups. Utilization of SGLT‐2 inhibitors was particularly high in patients with prior heart failure. Conclusions In adults with new onset type 2 diabetes, GLP‐1 receptor agonist and SGLT‐2 inhibitor utilization has markedly increased, coordinating with evolving guidelines that emphasize cardiovascular and chronic kidney disease management. However, overall adoption rates of these medications remain low based on indicated populations. Sulfonylurea use declined while metformin remains the most frequently initiated treatment. |
| format | Article |
| id | doaj-art-ab87fab96d0e4e79a0b568a59b486b4d |
| institution | Kabale University |
| issn | 1753-0393 1753-0407 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes |
| spelling | doaj-art-ab87fab96d0e4e79a0b568a59b486b4d2025-08-20T03:27:44ZengWileyJournal of Diabetes1753-03931753-04072025-06-01176n/an/a10.1111/1753-0407.70108Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline LandscapeWilliam Hou0Katherine R. Tuttle1Weining Shen2Andrew Reikes3Jonathan H. Watanabe4Donald Bren School of Information and Computer Sciences University of California Irvine California USANephrology Division University of Washington School of Medicine Seattle Washington USADepartment of Statistics University of California Irvine California USADivisions of General Internal Medicine and Endocrinology, Department of Medicine University of California, Irvine School of Medicine Irvine California USADepartment of Clinical Pharmacy University of California San Francisco San Francisco California USAABSTRACT Aims In patients with new onset type 2 diabetes, this study aimed to analyze glucose‐lowering medication use patterns between 2014 and 2022. Materials and Methods This retrospective study included adults with incident type 2 diabetes in the University of California Health System between 2014 and 2022. We determined medications used within 1 year of diagnosis and evaluated statistical evidence of use pattern changes via Mann–Kendall trend tests. Four categories of high‐risk patients requiring cardio‐kidney‐metabolic protection were also evaluated in stratified analyses based on 2024 ADA guidelines. Results Of 40 150 patients with incident type 2 diabetes, 38.5% initiated glucose‐lowering medication within 1 year. Metformin remained the most used medication from 2014 to 2022. From 2014 to 2022, usage of GLP‐1 receptor agonists and SGLT‐2 inhibitors increased exponentially. GLP‐1 receptor agonist use increased from below 2.5%–21%. While SGLT‐2 inhibitor use increased from less than 2.5%–14%. This growth coincided with a decline in sulfonylurea usage. Among high‐risk, insulin was most prevalent in those with heart failure or chronic kidney disease. However, usage of insulin declined overall in all groups. Utilization of SGLT‐2 inhibitors was particularly high in patients with prior heart failure. Conclusions In adults with new onset type 2 diabetes, GLP‐1 receptor agonist and SGLT‐2 inhibitor utilization has markedly increased, coordinating with evolving guidelines that emphasize cardiovascular and chronic kidney disease management. However, overall adoption rates of these medications remain low based on indicated populations. Sulfonylurea use declined while metformin remains the most frequently initiated treatment.https://doi.org/10.1111/1753-0407.70108antidiabetic medicationscardiovascular diseasediabetesguidelinesinsulinsmetformin |
| spellingShingle | William Hou Katherine R. Tuttle Weining Shen Andrew Reikes Jonathan H. Watanabe Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape Journal of Diabetes antidiabetic medications cardiovascular disease diabetes guidelines insulins metformin |
| title | Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape |
| title_full | Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape |
| title_fullStr | Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape |
| title_full_unstemmed | Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape |
| title_short | Trends in Pharmacological Treatment of Patients With New Onset Type 2 Diabetes: Usage Patterns in an Evolving Guideline Landscape |
| title_sort | trends in pharmacological treatment of patients with new onset type 2 diabetes usage patterns in an evolving guideline landscape |
| topic | antidiabetic medications cardiovascular disease diabetes guidelines insulins metformin |
| url | https://doi.org/10.1111/1753-0407.70108 |
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