Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes : Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
Franch-Nadal, Josep (Institut Català de la Salut)
Mata-Cases, Manel (Institut Català de la Salut)
Ortega, Emilio (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición)
Real, Jordi (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Gratacòs, Mònica (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Vlacho, Bogdan (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Vallés, Joan Antoni (Institut Català de la Salut)
Mauricio, Didac (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	To assess the clinical characteristics, the prescription pattern of GLP-1 receptor agonists (GLP-1RA) users, and HbA1c and weight change, we retrospectively assessed patients with type 2 diabetes by initiating GLP-1RA as an add-on to the standard of care in Catalonia. The mean change from the baseline in glycated hemoglobin (HbA1c) and weight at 6 and 12 months of therapy was calculated, and we assessed the predictors of the HbA1c reduction of ≥1% and/or the weight reduction of ≥3% as recommended by the Catalan Health Service. In 2854 patients who initiated a GLP-1RA during 2014 and 2015, the overall mean HbA1c values were reduced from the baseline by -0. 84% (SD = 1. 66) (-9. 2 mmol/mol) and lost on average 2. 73 kg (SD = 6. 2). About 44% percent of patients decreased their HbA1c by ≥1%; 44% decreased their weight by ≥3%; and only 22% met both of them together. The odds of achieving a reduction of ≥1% in initial HbA1c were two-fold higher for patients with higher baseline levels, and the likelihood of a reduction of ≥3% in the initial weight was associated with a higher BMI at the baseline, but they were independent of each other. The composite outcome (target 1% HbA1c reduction and 3% weight loss) to evaluate both the GLP-1RA clinical benefit and treatment withdrawal should be judged from a patient-centered approach.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	GLP-1 analogue ; Type 2 diabetes mellitus ; Primary care ; Observational study ; Glycaemic control
Published in:	Journal of clinical medicine, Vol. 8 (september 2019) , ISSN 2077-0383

DOI: 10.3390/jcm8091389
PMID: 31491916

17 p, 890.5 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles