Drug prescription in men and women with type-2 diabetes in Stockholm in 1995 and 2001: change over time.

Abstract

To describe, and compare between 1995 and 2001, the distribution of prescribed drugs in diabetic men and women. Two cross-sectional surveys of medical records of diabetic patients with type-2 diabetes were carried out in two primary health care centres in Stockholm County; age 35-64 years; 59 men and 43 women in 1995, and 80 men and 80 women in 2001. Prescriptions of pharmaceutical preparations, metabolic outcome, cardiovascular risk factors and diabetes-related co-morbidity were noted. Correlation of significant outcomes was performed using logistic regression. The pattern of antidiabetic therapy changed between 1995 and 2001 ( P=0.001), with fewer subjects treated with insulin (15% vs 3%), and more subjects with tablets and insulin combined (13% vs 23%). Prescription rate of sulphonylureas decreased (54% vs 41%; P=0.035), and rate of metformin increased (34% vs 48%; P=0.035). The use of lipid-lowering agents rose from 14% to 37% ( P<0.001). Mean HbA1c value decreased ( P<0.001; 7.6%-units vs 6.5%-units), as did mean cholesterol value ( P<0.001; 5.9 mmol/l vs 5.3 mmol/l). The rate of macrovascular complications decreased among men from 39% to 21% ( P=0.027) and among women regarding coronary heart disease from 26% to 6% ( P=0.003). Improvement in metabolic control and complications was not associated with the changed prescription pattern. Improved metabolic and cardiovascular outcomes were found, but were not correlated with the simultaneous changed prescription pattern, with increased use of combined insulin and oral antidiabetics, of metformin or of lipid-lowering drugs.