Trillium Health Partners & Unity Health Toronto, Mississauga, Ontario, Canada.
LMC Diabetes & Endocrinology, Concord, Ontario, Canada.
Can J Diabetes. 2023 Jul;47(5):398-404. doi: 10.1016/j.jcjd.2023.03.001. Epub 2023 Mar 21.
Diabetes is a major public health problem in Canada and requires multifactorial, consistent clinical management. The COVID-19 pandemic has increased challenges in the management of many chronic ailments, including diabetes. Diabetes was associated with a higher risk of severe illness in the context of COVID-19. Pandemic restrictions also impacted diabetes care continuity, which may have contributed to an increased risk of diabetes-related complications and mortality.
This was a retrospective cross-sectional study of prescription patterns of antihyperglycemic medications claimed by individuals with type 2 diabetes (T2D) before and during the COVID-19 pandemic using the IQVIA Canada Longitudinal Prescription Claims database. The study period was from March 1, 2018, to February 28, 2021. The study outcomes are described on a monthly, quarterly, and yearly basis and overall, and by medication, medication class, and insurance coverage type. "New-to-molecule" patients were defined as those claiming a medication during the analysis period that they had no history of claiming in the database. Adults with at least 1 year of prescription history available and claiming their first prescription for an antihyperglycemic drug during the analysis period were classified as newly diagnosed with T2D.
A similar number of people had at least 1 non-insulin antihyperglycemic prescription during the baseline, prepandemic, and pandemic periods in Canada (1,778,155, 1,822,403, and 1,797,272, respectively). However, the number of people initiating newer antihyperglycemic medications decreased at the beginning of the pandemic, in contrast to older medications, which remained consistent across the pandemic period. The number of people diagnosed with T2D decreased in the early months of the pandemic but recovered by October 2020.
The COVID-19 epidemic in Canada impacted clinical care for at-risk Canadians, with fewer being prescribed newer antihyperglycemic drugs and a reduction in the number of diagnoses of T2D.
糖尿病是加拿大的一个主要公共卫生问题,需要多方面的、持续的临床管理。COVID-19 大流行增加了许多慢性病管理的挑战,包括糖尿病。在 COVID-19 背景下,糖尿病与严重疾病的风险增加有关。大流行限制也影响了糖尿病护理的连续性,这可能导致糖尿病相关并发症和死亡率的风险增加。
这是一项使用 IQVIA 加拿大纵向处方索赔数据库,对 2 型糖尿病(T2D)患者在 COVID-19 大流行前后抗高血糖药物处方模式进行的回顾性横断面研究。研究期间为 2018 年 3 月 1 日至 2021 年 2 月 28 日。研究结果按月、按季和按年以及按药物、药物类别和保险覆盖类型描述。“新分子”患者定义为在分析期间声称使用药物,但在数据库中无用药史的患者。至少有 1 年处方史且在分析期间首次声称使用抗高血糖药物的成年人被归类为新诊断为 T2D。
在加拿大,基线期、大流行前和大流行期间,至少有 1 种非胰岛素抗高血糖药物处方的人数相似(分别为 1,778,155 人、1,822,403 人和 1,797,272 人)。然而,在大流行开始时,开始使用更新的抗高血糖药物的人数减少,而较旧的药物则在整个大流行期间保持一致。在大流行的头几个月,被诊断患有 T2D 的人数减少,但到 2020 年 10 月有所恢复。
加拿大的 COVID-19 疫情影响了高危加拿大人群的临床护理,较少人被开处新的抗高血糖药物,且 T2D 的诊断人数减少。