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( Yuko Watanabe ),( Miyuki Nogawa ),( Yoshiaki Kawagoe ),( Hitomi Fujii ),( Takaichi Miyakawa ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: The national health survey in 2011 estimated nearly 20 million Japanese adults are being or possibly having diabetes mellitus. Treatment for type 2 diabetes mellitus requires multiple oral antidiabetic agents (OADs) and/or insulin in the long run. In 2009, the . rst DPP-4 inhibitor sitagliptin launched, and currently seven DPP-4 inhibitors are available in Japan. Aim: We conducted this survey in order to reveal changes in pharmacological treatment pattern, especially before and after the introduction of DPP-4 inhibitors, and to delineate its ef. cacy on glycemic control. Methods: We reviewed the electric medical record from March 1st to May 31st in 2008, that is one year before the introduction of DPP-4 inhibitor, and the same period in 2013. As for pharmacological agents, we focused on six classes of OAD, Insulin and GLP-1 receptor agonists (GLP-1 RAs). Primary outcomes were the number and proportion of patient using each drug. Secondary outcome was mean HbA<sub>1c</sub>. Statistical analyses were performed by JMP5.0.1J using SAS. Results: Total number of patient increased by 40 % in 5 years. While SU and BG users increased moderately and insulin users tended to decrease, DPP-4 inhibitors use reached to 65% of the patients in 2013 (Table). TZD use remained the same despite bladder or other cancer issue, mainly because our mean dose was less than 15mg/d (median 7.5mg/d). Glinides and AGI use declined rapidly probably due to the restriction on DPP-4 inhibitors when prescribed. HbA<sub>1c</sub> improved signi. cantly (P<0.05) compared to year 2008. Conclusions: The introduction of DPP-4 inhibitor made treatment pattern changed substantially, and glycemic control improved. Further study is needed to evaluate cost-effectiveness of multiple drug combinations.
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