Many people with type 2 diabetes rely on a medication called metformin to help manage their blood sugar levels.
However, in most cases, metformin alone isn’t enough, and patients often need to add another medication to control their diabetes effectively.
This additional medication, known as a second-line medication, is crucial for many patients, but a new study from Northwestern Medicine reveals that adherence to these second-line drugs is a significant challenge.
When patients discontinue their medication, switch to a different drug, or intensify their treatment, it not only wastes time and money for both the doctor and the patient but can also result in inadequate management of type 2 diabetes.
This study, published in The American Journal of Managed Care, analyzed data from over 82,000 patients between 2014 and 2017.
It found that within one year of their initial prescription, nearly two-thirds of patients either stopped taking their medication, switched to a different medication, or increased their treatment.
The researchers examined five different classes of non-insulin diabetes medications and discovered that discontinuation rates were high in four of these classes, with 38% of patients discontinuing their medication.
However, the class known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) had the highest discontinuation rate, with 50% of patients discontinuing treatment.
David Liss, a research associate professor of general internal medicine at Northwestern University Feinberg School of Medicine and the corresponding author of the study, expressed concern about these high discontinuation rates.
He noted that when doctors prescribe a new medication to control type 2 diabetes, roughly half of the patients stop taking it within a year, which is not a favorable outcome.
While the study did not investigate the specific reasons behind medication discontinuation, Liss suggested that the high discontinuation rate of GLP-1 RAs might be due to adverse gastrointestinal side effects such as nausea, vomiting, and diarrhea.
These side effects are commonly associated with medications used for diabetes control and weight loss.
Interestingly, the study also found that discontinuation risk was lower and intensification risk was higher when an endocrinologist prescribed the medication compared to when a family medicine or internal medicine physician prescribed the second-line drugs.
Liss speculated that endocrinologists’ expertise in newer classes of diabetes drugs may have contributed to this difference.
Overall, this study highlights the need for improved prescribing approaches and a better understanding of the barriers patients face when taking these medications.
While discontinuing a second-line diabetes medication might not immediately lead to severe symptoms, it puts patients at greater risk for hospitalizations related to diabetes in the future.
Effective communication between patients and prescribers is crucial for better adherence to diabetes medications and improved patient outcomes.
If you care about diabetes, please read studies about new way to achieve type 2 diabetes remission, and one avocado a day keeps diabetes at bay.
For more information about diabetes, please see recent studies about 5 dangerous signs you have diabetes-related eye disease, and results showing why pomegranate is super fruit for people with diabetes.
The research findings can be found in The American Journal of Managed Care.
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