Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels.
OBJECTIVE
The aim of this study was to compare developments in the utilisation of antihyperglycaemic drugs (AHGDs) in ten European countries.


METHODS
Data on the yearly utilisation of insulin and oral AHGDs were collected from public registers in Denmark, Finland, Norway, Sweden, Belgium, England, Germany, Italy, Portugal and Spain, and were expressed as defined daily doses per 1,000 inhabitants per day.


RESULTS
Total AGHD utilisation increased everywhere, but at different rates and levels. Insulin utilisation doubled in England and Germany, but hardly changed in Belgium, Portugal or Italy. Sulfonylurea utilisation doubled in Spain, England and Denmark but was reduced in Germany and Sweden. Metformin utilisation increased greatly everywhere. There were two- to three-fold differences in AHGD utilisation even between neighbouring countries. In Finland, there were more users of both insulin (+120%) and oral AHGDs (+80%) than in Denmark, and the daily oral AHGD doses were higher. In Denmark and Sweden, AHGD utilisation was equal in subjects aged <45 years, but in those >or=45 years of age, both insulin and oral AHGD utilisation were twice as high in Sweden.


CONCLUSIONS
The ubiquitous increase in AHGD utilisation, particularly metformin, seems logical, considering the increasing prevalence of type 2 diabetes and the results of the UK Prospective Diabetes Study. However, the large differences even between neighbouring countries are more difficult to explain, and suggest different habits and attitudes in terms of screening and management of type 2 diabetes.
Melander
A
A
The NEPI Foundation, Department of Clinical Sciences, Malmö University Hospital, S-205 02, Malmö, Sweden. arne.melander@nepi.net
Folino-Gallo
P
P
Walley
T
T
Schwabe
U
U
Groop
P-H
PH
Klaukka
T
T
Vallano
A
A
Laporte
J-R
JR
Gallego
M R
MR
Schiappa
M
M
Røder
M
M
Kampmann
J P
JP
de Swaef
A
A
Aberg
M
M
Månsson
N-O
NO
Lindblad
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000188:drug therapy; D004363:Drug Utilization / Q000706:statistics & numerical data; D005060:Europe; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin