Prescribing Trends of Antidiabetes Medications in Patients With Type 2 Diabetes and Diabetic Kidney Disease, a Cohort Study.

Abstract

To assess changes in antidiabetes medication class prescriptions over time among patients with diabetic kidney disease (DKD), characteristics of patients prescribed these medications, and prescribers' specialty. We conducted a cohort study design using insurance claims data between 2013 and the first quarter of 2020 (2020Q1). Included are adult patients with DKD who initiated a new antidiabetes medication between 2013 and 2020Q1 (N = 160,489 patients). The primary outcome is the yearly and quarterly percent of medication initiation for each antidiabetes medication class over all antidiabetes medication initiations. For patients with DKD, sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucago-like peptide 1 receptor agonist (GLP-1RA) initiations steadily increased between 2013 and 2020Q1. Internists and endocrinologists were the most frequent prescriber specialties. Patients <65 years of age had a larger percentage of all initiations that were SGLT2i or GLP-1RA, 16% and 23%, respectively, in 2019, and patients >75 years of age had a smaller percentage of all initiations that were SGLT2i or GLP-1RA, 11% and 13%, in 2019. For patients with DKD, SGLT2i and GLP-1RA prescriptions have increased over time, likely reflecting evolving prescribing patterns in response to the results of recent clinical trials and new clinical guidelines.