title: Persistence of initial oral antidiabetic treatment in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Adequate persistence of oral antidiabetic treatment is highly important to achieve proper glycemic control in patients with type 2 diabetes. The aim of this study was to evaluate the persistence of initial treatment with metformin and/or sulphonylureas in patients with type 2 diabetes.
  
  
  METHODS
  The study was performed among diabetic patients (n=256,384) who were with newly prescribed oral antidiabetic drugs (metformin and/or sulphonylureas) between 2007 and 2009. For making comparison, patients with newly prescribed statin or clopidogrel therapy (with and without percutaneous coronary intervention) were investigated. The database of the Hungarian National Health Insurance Fund Administration was used.
  
  
  RESULTS
  The 1-year persistence of initial treatment with metformin, sulphonylureas or metformin/sulphonylurea combination was 47.7%, 45.4% and 55.8%, respectively, which was significantly better than the persistence of statin therapy (26.3%) but worse than that of clopidogrel therapy in patients undergoing coronary intervention (73.2%). Within the sulphonylurea group there was a tendency of better persistence of treatment with the "modified-release" tablets at 12 months compared to the conventional sulphonylureas (47.8 vs. 42.2%). The persistence of therapy using metformin 1000 mg - 60 tablets was significantly better (60.4%) at 12 months than that of other forms of metformin therapy with lower doses and smaller boxes (with fewer tablets) analyzed together (47.7%).
  
  
  CONCLUSIONS
  The persistence of initial treatment with metformin and/or sulphonylureas is far from optimal. Better diabetic care and continuous patient education should be encouraged to achieve higher persistence of oral antidiabetic treatment in patients with type 2 diabetes.
authors.affiliation: 3rd Department of Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary. gyjermendy@mail.datanet.hu
authors.forename: György
authors.initials: G
authors.lastname: Jermendy
authors.forename: István
authors.initials: I
authors.lastname: Wittmann
authors.forename: László
authors.initials: L
authors.lastname: Nagy
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Kiss
authors.forename: György
authors.initials: G
authors.lastname: Rokszin
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Abonyi-Tóth
authors.forename: Lajos
authors.initials: L
authors.lastname: Katona
authors.forename: György
authors.initials: G
authors.lastname: Paragh
authors.forename: István
authors.initials: I
authors.lastname: Karádi
authors.forename: Béla
authors.initials: B
authors.lastname: Merkely
mesh_terms: D000284:Administration, Oral; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use*; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D008687:Metformin