Cargando…

Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

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 baseli...

Descripción completa

Detalles Bibliográficos
Autores principales: Franch-Nadal, Josep, Mata-Cases, Manel, Ortega, Emilio, Real, Jordi, Gratacòs, Mònica, Vlacho, Bogdan, Vallés, Joan Antoni, Mauricio, Dídac
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780172/
https://www.ncbi.nlm.nih.gov/pubmed/31491916
http://dx.doi.org/10.3390/jcm8091389
_version_ 1783457067250483200
author Franch-Nadal, Josep
Mata-Cases, Manel
Ortega, Emilio
Real, Jordi
Gratacòs, Mònica
Vlacho, Bogdan
Vallés, Joan Antoni
Mauricio, Dídac
author_facet Franch-Nadal, Josep
Mata-Cases, Manel
Ortega, Emilio
Real, Jordi
Gratacòs, Mònica
Vlacho, Bogdan
Vallés, Joan Antoni
Mauricio, Dídac
author_sort Franch-Nadal, Josep
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6780172
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-67801722019-10-30 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 Mata-Cases, Manel Ortega, Emilio Real, Jordi Gratacòs, Mònica Vlacho, Bogdan Vallés, Joan Antoni Mauricio, Dídac J Clin Med Article 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. MDPI 2019-09-05 /pmc/articles/PMC6780172/ /pubmed/31491916 http://dx.doi.org/10.3390/jcm8091389 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Franch-Nadal, Josep
Mata-Cases, Manel
Ortega, Emilio
Real, Jordi
Gratacòs, Mònica
Vlacho, Bogdan
Vallés, Joan Antoni
Mauricio, Dídac
Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title_full Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title_fullStr Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title_full_unstemmed Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title_short Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia
title_sort glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes: prescription according to reimbursement constraints and guideline recommendations in catalonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780172/
https://www.ncbi.nlm.nih.gov/pubmed/31491916
http://dx.doi.org/10.3390/jcm8091389
work_keys_str_mv AT franchnadaljosep glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT matacasesmanel glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT ortegaemilio glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT realjordi glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT gratacosmonica glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT vlachobogdan glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT vallesjoanantoni glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia
AT mauriciodidac glucagonlikepeptide1receptoragonistsinpatientswithtype2diabetesprescriptionaccordingtoreimbursementconstraintsandguidelinerecommendationsincatalonia