title: [Characterization of and costs associated to the profile of patients with type 2 diabetes treated with metformin who are added a second oral antidiabetic drug: a population study].
abstract: OBJECTIVE
  To determine compliance, metabolic control, complications and healthcare costs of patients treated with metformin started a second antidiabetic drug in patients with type 2 diabetes (T2DM).
  
  
  METHODS
  Design multicenter observational retrospective. Patients were evaluated ≥30 years (age), treated with metformin and started a second antidiabetic treatment during 2008-2009. There were 4 patient groups (metformin and another antidiabetic): a) dipeptidyl peptidase-4 inhibitors (IDPP4), b) sulfonylureas, c) glitazones and d) insulin.
  
  
  METHODS
  comorbidity, metabolic control, compliance and complications. Patients were followed for 2 years. The cost model differed direct health costs (primary care / specialist) and indirect (labor productivity).
  
  
  METHODS
  logistic regression models and ANCOVA, p<0.05.
  
  
  RESULTS
  2067 patients were included (mean age: 66.6 years male: 53.1%). 25.1% started a second treatment with IDPP4; 42.9% sulfonylureas, 14.0% glitazones and 18.0% insulin. At 2 years follow-up, patients treated with IDPP4 showed greater adherence vs. 70.3%. 59.9%, 60.3% and 58.4; better control of 64.3% vs. DM2. 62.6%, 62.8% and 50.5% and a decrease of 13.9% compared to hypoglycaemia 40.4%, 37.6% and 58.9% respectively (p<0.001). The average / unit total costs was €2,321 vs. €2,475, €2,724 and €3,164, respectively, p<0.001. Rates of cardiovascular events and renal failure were 3.7%, 6.4%, 7.6% and 10.2% respectively.
  
  
  CONCLUSIONS
  Sulfonylureas were the most commonly used drugs. Patients treated with IDPP4 had higher compliance and control of diabetes, with lower rates of hypoglycaemia and healthcare costs.
authors.affiliation: Dirección de Planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España. Electronic address: asicras@bsa.cat.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras-Mainar
authors.forename: Beatriu
authors.initials: B
authors.lastname: Font-Ramos
authors.forename: Cecilia
authors.initials: C
authors.lastname: Roldán-Suárez
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro-Artieda
authors.forename: Jordi
authors.initials: J
authors.lastname: Ibáñez-Nolla
mesh_terms: D000284:Administration, Oral; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D004359:Drug Therapy, Combination; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000191:economics* / Q000627:therapeutic use*; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin
keywords: Cardiovascular event; Compliance; Control; Costes sanitarios; Cumplimiento; Diabetes; Evento cardiovascular; Healthcare costs; Hipoglucemias; Hypoglycaemias