title: Factors associated with initiation of antihyperglycaemic medication in UK patients with newly diagnosed type 2 diabetes.
abstract: OBJECTIVE
  To assess the factors associated with antihyperglycaemic medication initiation in UK patients with newly diagnosed type 2 diabetes.
  
  
  METHODS
  In a retrospective cohort study, patients with newly diagnosed type 2 diabetes were identified during the index period of 2003-2005. Eligible patients were ≥ 30 years old at the date of the first observed diabetes diagnosis (referred to as index date) and had at least 2 years of follow-up medical history (N = 9,158). Initiation of antihyperglycaemic medication (i.e., treatment) was assessed in the 2-year period following the index date. Adjusted Cox regression models were used to examine the association between time to medication initiation and patient age and other factors.
  
  
  RESULTS
  Mean (SD) HbA1c at diagnosis was 8.1% (2.3). Overall, 51% of patients initiated antihyperglycaemic medication within 2 years (65%, 55%, 46% and 40% for patients in the 30- < 45, 45- < 65, 65- < 75, 75+ age groups, respectively). Among the treated patients, median (25th, 75th percentile) time to treatment initiation was 63 (8, 257) days. Of the patients with HbA1c ≥ 7.5% at diagnosis, 87% initiated treatment within 2 years. These patients with a higher HbA1c also had shorter time to treatment initiation (adjusted hazard ratio (HR) = 2.44 [95% confidence interval (CI): 1.61, 3.70]; p < 0.0001). Increasing age (in years) was negatively associated with time to treatment initiation (HR = 0.98 [95% CI: 0.97, 0.99]; p < 0.001). Factors significantly associated with shorter time to treatment initiation included female gender and use of cardiovascular medications at baseline or initiated during follow up.
  
  
  CONCLUSIONS
  In this UK cohort of patients with newly diagnosed type 2 diabetes, only 51% had antihyperglycaemic medication initiated over a 2-year period following diagnosis. Older patients were significantly less likely to have been prescribed antihyperglycaemic medications. Elevated HbA1c was the strongest factor associated with initiating antihyperglycaemic medication in these patients.
authors.affiliation: Merck Sharp & Dohme Corp, Whitehouse Station, NJ, USA. panagiotis.mavros@merck.com.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Sinclair
authors.forename: Charles M
authors.initials: CM
authors.lastname: Alexander
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Davies
authors.forename: Changgeng
authors.initials: C
authors.lastname: Zhao
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Mavros