Utilization of glucose, blood pressure, and lipid lowering medications among people with type II diabetes in the United States, 1999-2010

Ann Epidemiol. 2014 Jul;24(7):516-21.e1. doi: 10.1016/j.annepidem.2014.05.001. Epub 2014 May 10.

Abstract

Purpose: Changes in relation to drug treatment to various control targets for diabetes were studied using the National Health and Nutrition Examination Survey, 1999-2010.

Methods: Data on 3094 participants aged 20 years or older with diagnosed type II diabetes were analyzed. Use of medications for lowering glucose, blood pressure, and lipids in the past month was assessed by questionnaire. Data from two survey cycles were combined together to produce estimates for each 4-year period.

Results: Usage of metformin increased from 34.8% to 53.8% and was the most prevalent medications during this period (P < .001), and half of subjects taking metformin could achieve glycated hemoglobin less than 7.0% in 2007-2010. Dipeptidyl peptidase-4 inhibitors were used by 7.4% of participants in 2007-2010. Usage of angiotensin receptor blockers and beta-blockers increased significantly from 7.4% to 21.4% and from 15.3% to 31.8%, respectively from 1999 to 2010 (P ≤ .001). A total of 64.7% of participants could attain blood pressure control by 2007-2010. Usage of statins doubled in 1999-2010 and 52.2% of subjects took statins by 2007-2010 (P < .001).

Conclusions: Metformin is the first-line drug for diabetes while dipeptidyl peptidase-4 inhibitors started to be used since 2007. Blood pressure control improved in 1999-2010 partly due to increased drug prescriptions. Although statins were widely used about half of the participants did not take them.

Keywords: Diabetes; NHANES; Prescription medications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiotensin Receptor Antagonists
  • Antihypertensive Agents / therapeutic use*
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Blood Pressure / drug effects
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / epidemiology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypoglycemic Agents / therapeutic use*
  • Hypolipidemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Outcome Assessment, Health Care
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prescription Drugs / administration & dosage
  • Surveys and Questionnaires
  • United States / epidemiology

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin Receptor Antagonists
  • Antihypertensive Agents
  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • Insulin
  • Prescription Drugs