Medical Sociology Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Accident and Emergency Department, St. Vincenz Hospital, Am Busdorf 2, 33098 Paderborn, Germany.
Int J Environ Res Public Health. 2023 Mar 3;20(5):4491. doi: 10.3390/ijerph20054491.
With an attempt to understand possible mechanisms behind the severity-dependent development of type 2 diabetes (T2D) comorbidities, this study examines the trends of antidiabetic and cardiovascular diseases (CVD) medication prescriptions in individuals with T2D.
The study is based on claims data from a statutory health insurance provider in Lower Saxony, Germany. The period prevalence of antidiabetic and CVD medication prescriptions was examined for the periods 2005-2007, 2010-2012, and 2015-2017 in 240,241, 295,868, and 308,134 individuals with T2D, respectively. (Ordered) logistic regression analyses were applied to examine the effect of time period on the number and prevalence of prescribed medications. Analyses were stratified by gender and three age groups.
The number of prescribed medications per person has increased significantly for all examined subgroups. For the two younger age groups, insulin prescriptions decreased but those of non-insulin medications increased, while both increased significantly over time for the age group of 65+ years. Except for glycosides and antiarrhythmic medications, the predicted probabilities for CVD medications increased over the examined periods, with lipid-lowering agents demonstrating the highest increase.
Results point towards an increase in medication prescriptions in T2D, which is in line with the evidence of the increase in most comorbidities indicating morbidity expansion. The increase in CVD medication prescriptions, especially lipid-lowering agents, could explain the specific development of severe and less severe T2D comorbidities observed in this population.
为了深入了解 2 型糖尿病（T2D）合并症严重程度相关的可能发病机制，本研究分析了 T2D 患者的降糖和心血管疾病（CVD）药物处方的变化趋势。
该研究基于德国下萨克森州法定健康保险提供商的索赔数据。分别在 240241、295868 和 308134 名 T2D 患者中，检查了 2005-2007、2010-2012 和 2015-2017 年期间的降糖和 CVD 药物处方的时期患病率。采用有序逻辑回归分析考察了时间段对处方药物数量和比例的影响。分析按性别和三个年龄组分层。
所有检查的亚组中，每人的处方药物数量都显著增加。对于两个较年轻的年龄组，胰岛素处方减少，但非胰岛素药物的处方增加，而对于 65 岁以上的年龄组，这两种药物的处方都随着时间的推移显著增加。除了糖苷和抗心律失常药物外，CVD 药物的预测概率在检查期间增加，降血脂药物的增加幅度最大。
结果表明 T2D 的药物处方增加，这与大多数合并症发病率增加的证据一致，表明发病率扩大。CVD 药物处方的增加，尤其是降血脂药物的增加，可能解释了在该人群中观察到的严重和较轻 T2D 合并症的具体发展。
