Utilisation of medications to lower blood pressure, glucose and lipids among people with type 2 diabetes in the National Health and Nutrition Examination Survey 1999-2010

Abstract

OBJECTIVE: Changes in drug treatment of diabetes in the United States were studied using data from the National Health and Nutrition Examination Survey 1999-2010. METHODS: Data on 3094 participants aged ≥20 years with diagnosed type 2 diabetes were analysed. The use of medications for lowering blood glucose, blood pressure (BP), 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 all three types of medications increased significantly from 1999-2002 to 2007-2010 (P < 0.01). Metformin was increasingly used from 34.8% to 53.8% during this period (P<7.0% in 2007-2010. Dipeptidyl peptidase-4 (DPP-4) inhibitors, approved in 2007, were used by 7.4% of the participants in 2007-2010. Usage of angiotensin receptor blockers (ARB) and beta-blockers increased from 7.4% to 21.4%, and from 15.3% to 31.8%, respectively, across the 12-year period (both P < 0.001). 52.2% of subjects took statins by 2007-2010 (P < 0.001). CONCLUSION: There were significant increases in the use of glucose, BP, and lipid-lowering medications during 1999-2010, especially in the use of metformin, ARB and beta-blockers. The increased BP drug prescription could lead to improved BP control. Metformin is the recommended first-line drug for diabetes, while DPP-4 inhibitors began to be used after their introduction. Although statins were widely used, about half of the participants did not take them.