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Changes in pharmacotherapy during the first 5 years after T2D diagnosis

In this study, investigators used data from the ADDITION-UK trial, a primary care-based screening and intervention study for type 2 diabetes. Their aim was to examine the nature of prescriptions for individuals with screen-detected diabetes at diagnosis, as well as 1 and 5 years post-diagnosis. They found that these individuals were likely to receive intensified pharmacotherapy to improve both glycaemic control and general cardiometabolic health. The treatment of diabetes was influenced by the underlying risk of cardiovascular disease, although many individuals did not start glucose lowering and cardioprotective therapies in the first 5 years after diagnosis.

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By Colin Kenny, GP, Dromore

The prescription histories of 1026 individuals with screen-detected diabetes enrolled in the ADDITION-UK trial of the promotion of intensive treatment were coded into general medication types at diagnosis and 1 and 5 years post-diagnosis. The association was explored between change in the count of several medication types and age, baseline 10-year UKPDS (UK Prospective Diabetes Study) cardiovascular risk, sex, intensive treatment group and number of medications.

Just under half of individuals (42%) were taking drugs unrelated to cardioprotection before diagnosis, and this was found to have increased post-diagnosis alongside a rise in the number of prescribed diabetes-related and cardioprotective drugs. Higher cardiovascular risk at baseline was associated with a greater increase in cardioprotective and diabetes-related medication, but not an increase in other medications. This suggests that there is a significant degree of multimorbidity and polypharmacy present in individuals with screen-detected diabetes. Following diagnosis, individuals were more likely to be prescribed diabetes-related medication if they were younger, female or had a higher cardiovascular risk.

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