Background Diabetes mellitus type 2 (DM2) is a chronic disease with major impact on morbidity and mortality and the use of health resources.
Purpose To analyse the evolution of consumption of antidiabetic drugs from 2001 to 2014. To study the variations in admissions due to lower extremity amputations from 2007 to 2013.
Material and methods Descriptive study of the use of antidiabetic drugs between 2001 and 2014. Field of study: two tertiary hospitals and their reference areas, the target population consisting of 675 000 people. Prescriptions under the National Health System coverage were studied. The unit of measure was defined daily doses (DDD) per 1000 inhabitants per day (DHD), using the anatomical therapeutic chemical (ATC)/DDD classification (2006). Hospitalisation data were collected from the hospital dat base. For statistical comparisons, the Student’s t test was used.
Results During the study period, consumption of insulins was maintained from 17.9 DHD to 18.3 DHD but oral agents increased from 41.3 DHD to 52.7 DHD. Consumption of sulfonylureas was gradually reduced from 30.1 DHD to 16.4 DHD but metformin (alone) usage increased from 4.3 DHD to 23.7 DHD, being the most consumed agent in 2014 (45% of consumption). Oral combinations were introduced in 2004 (0.1 DHD) and were the third most consumed group in 2014 (6.5 DHD). Consumption of dipeptidyl peptidase-4 inhibitors (since 2008) and ‘other hypoglycaemic agents’ increased from 0.3 DHD (2008) to 3.8 DHD and from 1.4 DHD to 2 DHD, respectively. On the other hand, the use of thiazolidinediones (since 2004) and alpha-glucosidase inhibitors was reduced from 0.7 DHD (2004) to 0.1 DHD and from 4.5 DHD to 0.2 DHD, respectively. The number of admissions due to lower extremity amputations from 2007 to 2013 was 94, 111, 145, 140, 125, 66 and 72, respectively. The number of amputations decreased significantly from 2008 to 2011 vs. 2013 (p < 0.05).
Conclusion Metformin (alone) remains the drug of choice in treating DM2.
Increased consumption of oral combinations could reflect more patients in more advanced stages of disease who do not respond to monotherapy.
To associate the decrease in admissions due to lower extremity amputations with a higher consumption of oral antidiabetic drugs, more studies are needed.
No conflict of interest.
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