Background and aims: Treatment of type 2 diabetes mellitus (T2DM) evolves with time, but little information is available regarding its determinants in the general population. We aimed to assess changes and determinants associated to antidiabetic treatment in a Swiss population-based sample.
Methods: Two hundred and ten participants with T2DM (136 men, mean±SD age 59.8±8.8 years). Antidiabetic drug treatment was assessed at baseline (2003-2006) and follow-up (2009-2012), and categorized into maintainers, changers and reducers/quitters.
Results: at baseline, 146 (69.5%) of the 210 participants received antidiabetic treatment. Of the 146 participants treated, 124 (84.9%) received oral antidiabetics alone, 8 (5.5%) insulin alone and 14 (9.6%) insulin and oral antidiabetics. During the 5.5 year follow-up, 108 (74.0%) patients maintained, 27 (18.5%) changed and 11 (7.5%) reduced or stopped treatment. Patients who changed therapy had higher baseline fasting plasma glucose (FPG) levels than the others (10.3±3.7 vs. 7.8±2.0 and 7.6±2.0 mmol/L for maintainers and reducers/quitters, respectively, p<0.001) and also lower levels of FPG<7.0 mmol/L (7.4%, vs. 39.8% and 45.5% for maintainers and reducers/quitters, respectively, p=0.002). At follow-up, patients who changed therapy had the highest prevalence of FPG decrease relative to baseline (55.6%, vs. 46.3% and 9.1% for maintainers and reducers/quitters, respectively, p=0.025).
Conclusion: during a 5.5 year follow-up less than one fifth of patients with T2DM had his/her drug treatment changed. Changes in antidiabetic treatment lead to an improvement of the unfavourable FPG status. The reasons and impact of quitting or reducing treatment should be further explored.