Patterns of Use of Noninsulin Antidiabetic Drugs in Colombia

OBJECTIVES: Type 2 diabetes mellitus (T2DM) is a prevalent disease that requires a patient-centered therapeutic approach, considering efficacy, safety, costs, and clinical characteristics. The patterns of T2DM drug use vary over time and with changes in clinical practice guidelines. The objective was to determine the prescription patterns of noninsulin antidiabetic drugs in a group of Colombian patients.

METHODS: Cross-sectional study. The monthly use of noninsulin antidiabetics during September-November 2022 was assessed from a drug-claim database that comprises a total population of 9 million patients from Colombia. Sociodemographic, drugs, and comorbidities data were evaluated. Drug usage is shown as frequencies, proportions, and defined daily doses per 1000 inhabitants/day (DHD).

RESULTS: A total of 155,381 patients with T2DM were identified. The mean age was 67.1 ± 12.0 years and 59.2% were women. The 80.9% used any drug containing metformin, 47.8% used a dipeptidyl peptidase type 4 inhibitors (DPP-4i), 43.5 % used sodium glucose cotransporter type 2 inhibitors (SGLT-2i), 7.2% used glucagon-like peptide-1 receptor agonists (GLP1-ra) and 2.5% used a sulfonylurea. The most used noninsulin antidiabetics were metformin (DHD: 9.46), empagliflozin (5.53), sitagliptin (2.86), linagliptin (2.44), dapagliflozin (2.30), vildagliptin (1.67) and semaglutide (0.04). The 44.4% of patients used monotherapy. The most frequent comedications were antihypertensives (77.2%), statins (72.7%) and non-opioid analgesics (40.0%). Antiplatelet drugs were used in 33.4% and 24.7% also had insulin.

CONCLUSIONS: This group of patients with T2DM has been treated mainly with metformin (alone or in combination), DDP-4i and SGLT-2i. Most patients also used drugs for cardiovascular conditions, highlighting the importance of assessing cardiovascular risk and selecting T2DM drugs accordingly.