ASL North-West Tuscany, Carrara, Italy.
ASP of Catania, Catania, Italy.
Diabetes Res Clin Pract. 2024 Aug;214:111781. doi: 10.1016/j.diabres.2024.111781. Epub 2024 Jul 11.
Describing the evolution over time in the use of sulfonylureas (SUs) and the characteristics of patients at first prescription and at interruption of treatment with SUs.
Retrospective evaluation of data from the Italian Association of Diabetologists (AMD) Annals registry (2010-2020), about T2D patients who started treatment with SUs. The longitudinal probability of remaining on SUs was estimated by Kaplan Meier survival curves.
SU prescription decreased from 30.7 % (2010) to 12.9 % (2020). Patients started on SU were 68.2 ± 11.2 years old, mostly males (55.5 %), with diabetes duration = 10.1 ± 8.3 years, BMI = 29.7 ± 5.5 kg/m2, and HbA1c = 8.3 ± 1.7 % [67 mmol/mol]. After one year, the probability of staying on SU was 85.4 %, 75.9 % after two years, 68.2 % after 3 years, 56.6 % after 5 years. Patients who discontinued SUs had higher BMI and HbA1c, were younger, more often males and treated with insulin. Over time, the percentage of subjects switched to metformin, DPP4i, SGLT2i, and GLP1RA increased, whereas use of glinides, glitazones, acarbose and insulin declined.
These data suggest a consensus, slowly, but increasingly aligning with the current National indications of dismissing SUs for the treatment of T2D. The new drugs for diabetes should represent a preferable choice in all patients who do not have specific contraindications.
描述磺酰脲类药物（SUs）的使用随时间的演变，以及首次处方和停止 SUs 治疗时患者的特征。
回顾性评估了来自意大利糖尿病协会（AMD）年报（2010-2020 年）的数据，该数据涉及开始使用 SUs 治疗的 2 型糖尿病（T2D）患者。通过 Kaplan-Meier 生存曲线估计继续使用 SUs 的纵向概率。
SU 处方率从 2010 年的 30.7%下降到 2020 年的 12.9%。开始使用 SU 的患者年龄为 68.2±11.2 岁，大多数为男性（55.5%），糖尿病病程=10.1±8.3 年，BMI=29.7±5.5kg/m2，HbA1c=8.3±1.7%[67mmol/mol]。一年后，继续使用 SU 的概率为 85.4%，两年后为 75.9%，三年后为 68.2%，五年后为 56.6%。停止使用 SUs 的患者 BMI 和 HbA1c 更高，年龄更小，更常为男性，并且接受胰岛素治疗。随着时间的推移，转换为二甲双胍、DPP4i、SGLT2i 和 GLP1RA 的患者比例增加，而使用格列奈类、吡格列酮、阿卡波糖和胰岛素的患者比例下降。
这些数据表明，尽管缓慢，但越来越多的人开始认同当前国家关于将 SUs 排除在 T2D 治疗之外的建议。对于没有特定禁忌症的所有患者，新型糖尿病药物应代表更优的选择。
