For adults newly diagnosed with T2DM, delays to first-line therapy are longest for older patients, those who are Black or of other minority eth- nicities, and those with multimorbidity, accord- ing to a study published in Diabetes, Obesity and Metabolism. Researchers examined factors asso- ciated with delays in receiving glucose-lowering therapy among 120,409 adults with T2DM init- iating first- to fourth-line glucose-lowering ther- apy in primary care between 2000 and 2018. Compared with those from the least deprived areas, patients from the most deprived areas re- ceived earlier first-line treatment. Most patients were treated with metformin, sulphonylureas, di- peptidyl peptidase IV inhibitors, and insulin as first-, second-, third-, and fourth-line prescrip- tions, respectively (82.4%, 50.4%, 27.7%, and 28.0%, respectively). The median times to pre- scription were 0.5, 4.1, 4.6, and 4.7 years for first-, second-, third-, and fourth-line glucose- lowering therapy, respectively. Twenty-five per- cent of patients developed cardiovascular (CV) disease and non-CV disease complications with- in a median of 12-14 years after T2DM diag- nosis and received intensification 5-6 years later. “The majority of patient with T2DM still remain in poor glycemic control and experience delays in early treatment intensification despite the in- creased number of therapies being available,” the authors wrote. “We recommend future health care research and guidelines to focus on over- coming therapeutic inertia.”

Author