Pharmacy World & Science

, 31:622 | Cite as

Change of initial oral antidiabetic therapy in type 2 diabetic patients

  • Arian PlatEmail author
  • Fernie Penning-van Beest
  • Sophia Kessabi
  • Martijn Groot
  • Ron Herings
Short Research Report


Objective To explore the ‘real-life’ therapy of type 2 diabetes mellitus with oral antidiabetic drugs (OADs). Methods From the PHARMO Record Linkage System comprising linked drug dispensing and clinical laboratory data from approximately 2.5 million individuals in the Netherlands, among others, new users of OADs were identified in the period 1999–2004. New users, aged 30 years and older, without insulin use before cohort entry date and with at least one year follow-up were included. We determined per initial therapy patient characteristics and first therapy change. Results Overall 35,514 patients were included. Metformin and sulfonylureas (SU) were the most frequent initial therapy. Patients on thiazolidinedione (TZD) monotherapy had lower percentages baseline HbA1c ≥ 7% compared to patients on metformin and SU. The proportion of patients still on initial therapy after one year ranged from 46% (TZDs) to around 60% (SU). Among patients starting on monotherapy, add-on (15–20%) and discontinuation (16–25%) of therapy occurred most frequently. In patients starting on combination therapy, a switch occurred in 30% of the patients. Conclusion In more than 40% of the patients a change in initial OAD-therapy is already observed in the first year of therapy. Maintaining patients on initial therapy remains a challenge.


Diabetes Netherlands Oral antidiabetic agents Pharmacoepidemiology Treatment pattern 



The authors wish to thank Sjoukje van der Bij for analyzing the data and Michiel van der Linden for his valuable comments on the manuscript.


This study was financially supported by an unrestricted grant from Novartis Pharma AG, Basel, Switzerland.

Conflict of interest statement

The PHARMO Institute performs financially supported studies for several pharmaceutical companies, including Novartis.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Arian Plat
    • 1
    Email author
  • Fernie Penning-van Beest
    • 1
  • Sophia Kessabi
    • 2
  • Martijn Groot
    • 3
  • Ron Herings
    • 4
    • 5
  1. 1.PHARMO Institute UtrechtThe Netherlands
  2. 2.Novartis Pharma AGBaselSwitzerland
  3. 3.Novartis Pharma B.V.ArnhemThe Netherlands
  4. 4.PHARMO InstituteUtrechtThe Netherlands
  5. 5.Department of Health Policy & ManagementErasmus Medical CentreRotterdamThe Netherlands

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