title: Time to initiation of oral antihyperglycemic and statin therapy in previously untreated patients with type 2 diabetes in the United States.
abstract: OBJECTIVE
  To assess the time from the first observed diagnosis of type 2 diabetes (T2DM) to initiation of an oral antihyperglycemic agent (OAHA) and statin.
  
  
  METHODS
  In a retrospective US cohort study using the GE electronic medical record database, patients ≥18 years were included if they had a T2DM diagnosis between January 1, 2004 and December 31, 2005 (index period), had a last pre-index HbA1c value ≥7%, and had not received antihyperglycemic agents within one year prior to diagnosis (index date). Patients were eligible for statin therapy but not on a statin within one year before the index date. Patients had medical records for one year prior to (baseline) and two years after (follow up) diagnosis.
  
  
  RESULTS
  Of the 2254 eligible patients, 58% were male, mean age was 58 years, mean HbA1c was 8.5%, and mean LDL cholesterol was 115 mg/dL (2.97 mmol/L) at baseline. Additionally, 21% of patients had pre-existing overt cardiovascular disease, 40% had dyslipidemia, 37% were obese, and 11% were smokers. During follow-up, 66.1% and 41.9% of patients initiated an OAHA and a statin, respectively. Among the treated patients, median time from the first observed diabetes diagnosis to therapy initiation was 3 months (interquartile range: 1, 9) for OAHAs and 6 months (2, 13) for statins.
  
  
  CONCLUSIONS
  Treatment initiation with injectable antihyperglycemic agents and/or non-statin lipid-modifying therapies as well as contraindications to OAHAs or statins were not assessed, therefore their impact on our study results cannot be determined. Laboratory measurements were not available for every patient and thus many patients were excluded from the analysis.
  
  
  CONCLUSIONS
  Treatment initiation with OAHAs and/or statins was suboptimal in patients with T2DM who were treatment eligible and previously untreated with OAHAs and statins. Of those treated, patients initiated treatment with an OAHA more often and earlier than with a statin.
authors.affiliation: Kailo Research Group, Fishers, IN, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Sun
authors.forename: Kaan
authors.initials: K
authors.lastname: Tunceli
authors.forename: Qiaoyi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Thomas
authors.initials: T
authors.lastname: Seck
authors.forename: Kristy
authors.initials: K
authors.lastname: Iglay
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Davies
authors.forename: Baishali
authors.initials: B
authors.lastname: Ambegaonkar
authors.forename: Larry
authors.initials: L
authors.lastname: Radican
mesh_terms: D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents