A study of newly initiated antidiabetic medication in primary care in Region Uppsala : A cross-sectional study

Background: T2DM patients can be treated with both Insulin or/and non-insulin antidiabetic drugs. Biguanide-derivate is the first-line antidiabetic that is cost-effective and safe. DPP-4Is are antidiabetic drugs that can be used to treat old patients and those with kidney failure. While SGLT2-inhibitors and GLP-1analogues can be used by T2DM patients with cardiovascular problems and those with overweight. The initiation of antidiabetic drug is influenced by several factors such as patient characteristic, physician’s knowledge and guidelines. Aim: The aim of this study was to study the type of antidiabetic medication initiated to naïve T2DM patients, how age and sex affect the choice of medication and difference in prescribing between Primary healthcare centers in Region Uppsala. Methods: The study was a cross-sectional based on health record data from Region Uppsala. The study included 2473 T2DM patients that were initiated antidiabetic medication between January 2019 and December 2020. Results: Non-insulins accounted for 88 % and insulins for 21.1% of the prescriptions. The proportion of men that received both insulin and non-insulins were higher than women. The proportion of patients that received insulins was higher for the age group 80 years and older. The proportion of men that received SGLT2- inhibitors was higher than for women, while women received more GLP-1- analogues. There was a variation between PHCs, but non-insulins were mostly prescribed at all PHCs. Conclusions: Initiation of antidiabetic drugs to naïve T2DM patients in region Uppsala fallowed the guidelines. There are some differences in prescription pattern between the two sexes and the age groups