title: The prevalence and treatment patterns of diabetes in the Greek population based on real-world data from the nation-wide prescription database.
abstract: OBJECTIVE
  Epidemiological data regarding diabetes in Greece are based on regional, small-scale studies. We aimed to identify all citizens with prescribed pharmacological treatment for diabetes, to further explore type 1 diabetes prevalence and describe pharmacological treatment patterns in type 2 diabetes.
  
  
  METHODS
  The electronic prescription database of the National Organization for Health Care Services Provision was used to identify individuals who received at least two prescriptions with an ICD-10 code relevant to diabetes, dispensed between June 1st, 2014 and May 31st, 2015. Type-1 diabetes was defined in those receiving at least two fully-reimbursable insulin prescriptions with an ICD-10 code of E10 (insulin-dependent diabetes).
  
  
  RESULTS
  The study population consisted of 10,222,779 individuals, accounting for 95% of the Greek population. Prevalence of medication-prescribed diabetes was 7.0% (720,764 individuals), ranging from 0.08% in children and adolescents, to 8.2% in adults, and 30.3% in those ⩾75years old. Prevalence of type 1 diabetes was 0.24%, with a clear male predominance and more than half of cases developing after 14years of age. Metformin was the most frequently prescribed medication (77.4%) in type-2 diabetes followed by DPP-4 inhibitors (44.8%) and sulphonylureas (34.5%), while insulin was used by 19.4% of patients.
  
  
  CONCLUSIONS
  This nation-wide real-world data analysis on medication-prescribed diabetes demonstrates that the current prevalence in Greece is 7.0%, with wide age variation and high figures in older adults. Identification of pharmacological patterns among patients with type 2 diabetes is a valuable guide in policy-makers' efforts to balance a cost-effective, quality-acceptable disease management.
authors.affiliation: First Department of Propaedeutic Internal Medicine, Diabetes Center, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece. Electronic address: sliatis@med.uoa.gr.
authors.forename: Stavros
authors.initials: S
authors.lastname: Liatis
authors.affiliation: First Department of Propaedeutic Internal Medicine, Diabetes Center, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece.
authors.forename: George E
authors.initials: GE
authors.lastname: Dafoulas
authors.affiliation: Medicines Department, National Organization for Health Care Services Provision, Athens, Greece.
authors.forename: Chara
authors.initials: C
authors.lastname: Kani
authors.affiliation: Medicines Department, National Organization for Health Care Services Provision, Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Politi
authors.affiliation: Medicines Department, National Organization for Health Care Services Provision, Athens, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Litsa
authors.affiliation: First Department of Propaedeutic Internal Medicine, Diabetes Center, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece.
authors.forename: Petros P
authors.initials: PP
authors.lastname: Sfikakis
authors.affiliation: First Department of Propaedeutic Internal Medicine, Diabetes Center, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Makrilakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; D008687:Metformin
keywords: Diabetes prevalence; Prescription database; Treatment patterns; Type 1 diabetes prevalence