title: Prescribing practices and clinical predictors of glucose-lowering therapy within the first year in people with newly diagnosed Type 2 diabetes.
abstract: OBJECTIVE
  To examine prescribing practices and predictors of glucose-lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting.
  
  
  METHODS
  We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010-2013. We used Poisson regression to compute age- and gender-adjusted risk ratios (RRs).
  
  
  RESULTS
  Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose-lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [RR: 1.29 (95% CI: 1.16-1.44) and 3.60 (95% CI: 2.36-5.50)]; high Charlson Comorbidity Index [RRs: 1.20 (95% CI: 1.05-1.38) and 2.08 (95% CI: 1.16-3.72)]; central obesity [RRs: 1.23 (95% CI: 1.04-1.44) and 1.93 (95% CI: 0.76-4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [RRs: 1.25 (95% CI: 1.10-1.42) and 1.94 (95% CI: 1.02-3.71)]; and HbA1c ≥ 59 mmol/mol (≥ 7.5%) [RR: 1.26 (95% CI: 1.20-1.32) and 2.86 (95% CI: 1.97-4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C-peptide of < 300 pmol/l also predicted therapy.
  
  
  CONCLUSIONS
  Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Mor
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Berencsi
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: E
authors.initials: E
authors.lastname: Svensson
authors.affiliation: Department of Biomedicine, Aarhus University Hospital, Aarhus, Denmark.|Center for Diabetes Research, Gentofte University Hospital, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Rungby
authors.affiliation: Diabetes Research Centre, Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors.forename: J S
authors.initials: JS
authors.lastname: Nielsen
authors.affiliation: Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Friborg
authors.affiliation: Department of Biochemistry, Lillebaelt Hospital, Vejle, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Brandslund
authors.affiliation: Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: J S
authors.initials: JS
authors.lastname: Christiansen
authors.affiliation: Department of Endocrinology, Rigshospitalet and Copenhagen University, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Vaag
authors.affiliation: Diabetes Research Centre, Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Beck-Nielsen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: H T
authors.initials: HT
authors.lastname: Sørensen
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: R W
authors.initials: RW
authors.lastname: Thomsen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D058005:General Practitioners; D020445:Hospitalists; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications; D010044:Outpatient Clinics, Hospital; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012042:Registries
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin