Background: Understanding the long-term cardiovascular safety of type 2 diabetes (T2D) medications is a high-priority research area. We used electronic medical record (EMR) data in the National Patient Centered Clinical Research Network (PCORnet) to characterize “real-world” use of T2D medications.

Methods and Results: We identified a retrospective cohort of patients with T2D using a validated computable phenotype. We queried 4 unique PCORnet sites for data regarding T2D medication use in the 90 days before and after cohort entry. We described patient demographics, comorbidities, non-T2D medication use, and clinical variables in the 730 days prior to cohort entry. We identified 49,654 patients with T2D across the 4 sites (range: 2,276-20,322). Use of T2D medications, characterized by pharmacologic class, and selected characteristics are presented in Table. Among patients prescribed a single class of T2D medication, metformin was the most common (52.5%). Among patients prescribed multiple classes of T2D agents, the most common combination was metformin and sulfonylureas (49%).

Conclusions: Across 4 PCORnet sites, metformin-based regimens were very prevalent, and approximately 10% of regimens included newer agents. PCORnet will be a valuable resource for future observational studies of T2D medications and long-term cardiovascular outcomes in “real-world” populations.
graphic
View largeDownload slide
Disclosure

K.N. Bachmann: Stock/Shareholder; Self; Medtronic. C. Roumie: None. A.D. Wiese: None. C.G. Grijalva: None. J.B. Buse: Consultant; Self; Neurimmune AG. Research Support; Self; AstraZeneca, National Center for Advancing Translational Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk A/S, Sanofi, vTv Therapeutics. Stock/Shareholder; Self; Mellitus Health, PhaseBio Pharmaceuticals, Inc., Stability Health. Other Relationship; Self; ADOCIA, AstraZeneca, Dance Biopharm Holdings Inc., Eli Lilly and Company, MannKind Corporation, NovaTarg, Novo Nordisk A/S, Senseonics, vTv Therapeutics, Zafgen, Inc. R. Bradford: None. E.O. Zalimeni: None. P. Knoepp: None. H.L. Morris: None. W.T. Donahoo: None. N. Fanous: None. V. Fonseca: Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Abbott, Asahi Kasei Corporation, Novo Nordisk Inc., Sanofi US, Takeda Pharmaceutical Company Limited. Research Support; Self; Bayer US. Stock/Shareholder; Self; Amgen Inc., BRAVO4HEALTH, Mellitus Health. B. Katalenich: None. M.M. Cook: None. R.L. Rothman: Consultant; Self; Abbott, edlogics. R.J. Chakkalakal: None.

Funding

National Institutes of Health (UL1TR002489, UL1TR002489); U.S. Department of Veterans Affairs (IK2CX001678); Patient-Centered Outcomes Research Institute (CDRN-1306-04869)

© 2019 by the American Diabetes Association.
2019
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.