Prescribing practices and clinical predictors of glucose‐lowering therapy within the first year in people with newly diagnosed Type 2 diabetes

Aim To examine prescribing practices and predictors of glucose‐lowering therapy within the first year following diagnosis of Type 2 diabetes mellitus in a clinical care setting. Methods We followed people enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes ( DD 2) cohort from outpatient hospital clinics and general practices throughout Denmark in 2010–2013. We used Poisson regression to compute age‐ and gender‐adjusted risk ratios ( RR s). Results Among 1158 new Type 2 diabetes mellitus patients, 302 (26%) did not receive glucose‐lowering therapy within the first year, 723 (62%) received monotherapy [685 (95%) with metformin], and 133 (12%) received more than one drug. Predictors of receiving any vs. no therapy and combination vs. monotherapy were: age < 40 years [ RR : 1.29 (95% CI : 1.16–1.44) and 3.60 (95% CI : 2.36–5.50)]; high Charlson Comorbidity Index [ RR s: 1.20 (95% CI : 1.05–1.38) and 2.08 (95% CI : 1.16–3.72)]; central obesity [ RR s: 1.23 (95% CI : 1.04–1.44) and 1.93 (95% CI : 0.76–4.94)]; fasting blood glucose of ≥ 7.5 mmol/l [ RR s: 1.25 (95% CI : 1.10–1.42) and 1.94 (95% CI : 1.02–3.71)]; and HbA 1c  ≥ 59 mmol/mol (≥ 7.5%) [ RR : 1.26 (95% CI : 1.20–1.32) and 2.86 (95% CI : 1.97–4.14)]. Weight gain ≥ 30 kg since age 20, lack of physical exercise and C–peptide of < 300 pmol/l also predicted therapy. Conclusions Comorbidity, young age, central obesity and poor baseline glycaemic control are important predictors of therapy one year after Type 2 diabetes mellitus debut.