Joyce Guo.
A nationwide study by a medical student, Joyce Guo, and researchers from the Pharmacoepidemiology Research Network has found that real-world type 2 diabetes treatment patterns are complex and not always consistent with guidelines.
Good glycaemic control is vital for preventing the complications of type 2 diabetes and guidelines in New Zealand and internationally recommend that people with type 2 diabetes who require pharmacological therapy are started on metformin monotherapy as first-line treatment, followed by escalation in a step-wise fashion to other therapeutic regimens if glycaemic control remains poor.
The study explored the treatment pathways of 93,874 New Zealanders who started metformin monotherapy as first-line therapy for type 2 diabetes between 2006 and 2014, and examined the time to change of therapy from metformin monotherapy, as well as the sequence in which subsequent therapeutic regimens were introduced.
The researchers found that the majority of people who transitioned from metformin monotherapy started a recommended second-line therapy, however many who escalated from a second-line therapy moved to a third-line therapy that differed from those which were recommended.
The study, reported in BMJ Open, was based on anonymised pharmaceutical dispensing and health data from the Ministry of Health.
Funding: Joyce Guo received an Otago Medical Research Foundation Summer Scholarship Award.Publication details:
Treatment escalation patterns in people with type 2 diabetes: a nationwide cohort study of new users of metformin monotherapy in New Zealand
Guo J* / Parkin L*, Zeng J, Barson D, Horsburgh S. *Joint first authors.
BMJ Open