Download PDF
Exp Clin Endocrinol Diabetes 2024; 132(09): 515-521
DOI: 10.1055/a-2307-4631
Article

Prevalence and Incidence of Medication-Treated Diabetes and Pattern of Glucose-Lowering Treatment During the COVID-19 Pandemic: Real-World Data from the Electronic Greek Prescription Database

C. Siafarikas 
1   First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
,
G. Karamanakos
1   First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
,
K. Makrilakis
1   First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
,
A. Tsolakidis
2   e-Government Center for Social Security Services (IDIKA), Athens, Greece
,
K. Mathioudakis
2   e-Government Center for Social Security Services (IDIKA), Athens, Greece
,
S. Liatis
1   First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
› Author Affiliations Funding Sources This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objectives This study aimed to investigate the prevalence and incidence of medication-treated diabetes mellitus and the evolving patterns of glucose-lowering treatments the year before and during the first two years of the coronavirus disease 2019 (COVID-19) pandemic.

Methods Data from the Greek electronic prescription database were analyzed for 2019, 2020, and 2021. The study population included individuals with active social security numbers. Prevalence and incidence rates were calculated based on the dispensing of glucose-lowering medications according to their unique anatomical therapeutic chemical (ATC) code.

Results The study population comprised 10,289,140 individuals in 2019, 10,630,726 in 2020, and 11,246,136 in 2021. Diabetes prevalence rates were 8.06%, 6.89%, and 7.91%, and incidence rates were 16.8/1000, 8.6/1000, and 13.4/1000 individuals, respectively. Metformin was the most prescribed medication, and newer classes, like sodium-glucose cotransporter-2 inhibitors 2 (SGLT-2) inhibitors and glucagon like peptide-1 (GLP-1) receptor agonists exhibited increasing trends.

Conclusions The study identified a decrease in medication-prescribed diabetes prevalence and incidence during the initial year of the COVID-19 pandemic, attributed to healthcare access restrictions. Subsequently, figures returned close to baseline levels. Glucose-lowering medication trends reflected adherence to local and international guidelines, with metformin as the cornerstone, and increasing preference for newer classes such as GLP-1 receptor agonists and SGLT-2 inhibitors.

Keywords

diabetes mellitus - prevalence - incidence - treatment - COVID-19 infection


Publication History

Received: 13 January 2024
Received: 24 March 2024

Accepted: 16 April 2024

Accepted Manuscript online:
16 April 2024

Article published online:
03 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Lin X, Xu Y, Pan X. et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025. Sci Rep 2020; 10: 14790
    CrossrefPubMedSearch in Google Scholar
  • 2 Disease GBD, Injury I, Prevalence C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1789-1858
    CrossrefPubMedSearch in Google Scholar
  • 3 Saeedi P, Petersohn I, Salpea P. et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract 2019; 157: 107843
    CrossrefPubMedSearch in Google Scholar
  • 4 Economou C, Kaitelidou D, Karanikolos M. et al. Greece: Health System Review; Health Syst Transit. 2017. 19. 1-166
    Search in Google Scholar
  • 5 Liatis S, Dafoulas GE, Kani C. et al. The prevalence and treatment patterns of diabetes in the Greek population based on real-world data from the nation-wide prescription database. Diabetes Res Clin Pract 2016; 118: 162-167
    CrossrefPubMedSearch in Google Scholar
  • 6 Makrilakis K, Kalpourtzi N, Ioannidis I. et al. Prevalence of diabetes and pre-diabetes in Greece. Results of the First National Survey of Morbidity and Risk Factors (EMENO) study. Diabetes Res Clin Pract 2021; 172: 108646
    CrossrefPubMedSearch in Google Scholar
  • 7 D'Souza D, Empringham J, Pechlivanoglou P. et al. Incidence of diabetes in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis. JAMA Netw Open 2023; 6: e2321281
    CrossrefPubMedSearch in Google Scholar
  • 8 Mefford MT, Wei R, Lustigova E. et al. Incidence of diabetes among youth before and during the COVID-19 pandemic. JAMA Netw Open 2023; 6: e2334953
    CrossrefPubMedSearch in Google Scholar
  • 9 Xie Y, Al-Aly Z. Risks and burdens of incident diabetes in long COVID: A cohort study. Lancet Diabetes Endocrinol 2022; 10: 311-321
    CrossrefPubMedSearch in Google Scholar
  • 10 Zhang T, Mei Q, Zhang Z. et al. Risk for newly diagnosed diabetes after COVID-19: A systematic review and meta-analysis. BMC Med 2022; 20: 444
    CrossrefPubMedSearch in Google Scholar
  • 11 Tittel SR, Rosenbauer J, Kamrath C. et al. Did the COVID-19 lockdown affect the incidence of pediatric type 1 diabetes in Germany?. Diabetes Care 2020; 43: e172-e173
    CrossrefPubMedSearch in Google Scholar
  • 12 Krischer JP, Lernmark Å, Hagopian WA. et al. SARS-CoV-2 - No increased Islet autoimmunity or type 1 diabetes in teens. N Engl J Med 2023; 389: 474-475
    CrossrefPubMedSearch in Google Scholar
  • 13 Dayal D, Gupta S, Raithatha D. et al. Missing during COVID-19 lockdown: Children with onset of type 1 diabetes. Acta Paediatr 2020; 109: 2144-2146
    CrossrefPubMedSearch in Google Scholar
  • 14 Carr MJ, Wright AK, Leelarathna L. et al. Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: A UK-wide cohort study involving 618 161 people in primary care. BMJ Qual Saf 2022; 31: 503-514
    CrossrefPubMedSearch in Google Scholar
  • 15 Mathieu C, Pambrun E, Benard-Laribiere A. et al. Impact of the COVID-19 pandemic and its control measures on cardiovascular and antidiabetic drugs use in France in 2020: A nationwide repeated cohort study. Eur J Epidemiol 2022; 37: 1049-1059
    CrossrefPubMedSearch in Google Scholar
  • 16 Cheng AYY, Goldenberg R, Krawchenko I. et al. Impact of the COVID-19 pandemic on antihyperglycemic prescriptions for adults with type 2 diabetes in Canada: A cross-sectional study. Can J Diabetes 2023; 47: 398-404
    CrossrefPubMedSearch in Google Scholar
  • 17 Davies MJ, Aroda VR, Collins BS. et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2022; 65: 1925-1966
    CrossrefPubMedSearch in Google Scholar
  • 18 Diabetes AH. Guidelines for the treatment of diabetes mellitus. In. Online; 2023: Guidelines for the treatment of diabetes mellitus
    PubMed
  • 19 Tsapas A, Avgerinos I, Karagiannis T. et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes: A systematic review and network meta-analysis. Ann Intern Med 2020; 173: 278-286
    CrossrefPubMedSearch in Google Scholar
  • 20 Patoulias DI, Boulmpou A, Teperikidis E. et al. Cardiovascular efficacy and safety of dipeptidyl peptidase-4 inhibitors: A meta-analysis of cardiovascular outcome trials. World J Cardiol 2021; 13: 585-592
    CrossrefPubMedSearch in Google Scholar
  • 21 Makrilakis K. The Role of DPP-4 inhibitors in the treatment algorithm of type 2 diabetes mellitus: When to select, what to expect. Int J Environ Res Public Health 2019; 16: 2720
    CrossrefPubMedSearch in Google Scholar
  • 22 Mardetko N, Nabergoj Makovec U, Locatelli I. et al. Uptake of new antidiabetic medicines in 11 European countries. BMC Endocr Disord 2021; 21: 127
    CrossrefPubMedSearch in Google Scholar
  • 23 Chen HB, Yang YL, Yu TH. et al. SGLT2 inhibitors for the composite of cardiorenal outcome in patients with chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials. Eur J Pharmacol 2022; 936: 175354
    CrossrefPubMedSearch in Google Scholar
  • 24 Engler C, Leo M, Pfeifer B. et al. Long-term trends in the prescription of antidiabetic drugs: Real-world evidence from the Diabetes Registry Tyrol 2012-2018. BMJ Open Diabetes Res Care 2020; 8: e001279
    CrossrefPubMedSearch in Google Scholar
  • 25 Shirabe S, Yamazaki K, Oishi M. et al. Changes in prescription patterns and doses of oral antidiabetic drugs in Japanese patients with type 2 diabetes (JDDM70. J Diabetes Investig 2023; 14: 75-80
    CrossrefPubMedSearch in Google Scholar