The 2018 ADA-EASD consensus report recommends GLP-1 RAs over BI as the first injectable medication in most patients with T2D. The objective of this U.S. retrospective observational study was to compare 1-year real-world glycemic effectiveness among patients with T2D initiating DU vs. BI.

Patients ≥18 years with T2D initiating DU or BI between Nov’14 - Apr’17 (index date=earliest fill date), and no claim for any antidiabetic injectable in 6 months pre-index period (baseline), continuous enrollment and ≥1 HbA1c result 6 months pre-index and 1-year post-index were identified from a U.S. claims database. DU users were propensity-matched 1:1 to BI users.

The pre-matching mean baseline HbA1c for DU cohort (n=1,103) was 8.4% vs. 9.9% for BI cohort (n=3,193). Matched cohorts (903 pairs) were balanced in baseline characteristics with mean HbA1c: ∼8.6%, mean age: 54 years, SGLT2 inhibitor use: 24% and DPP-4 inhibitor use: ∼38%. At 1-year post-index, 11% of DU cohort used BI and 10% of BI cohort used GLP-1 RAs; DU patients used less rapid-acting insulin (2% vs. 16%) and DPP-4 inhibitors (24% vs. 39%) and more SGLT2 inhibitors (34% vs. 23%) vs. BI patients. The key glycemic effectiveness results are included in the Table.

In this real-world study, patients with T2D initiating DU demonstrated significantly greater and clinically meaningful HbA1c reduction compared to those initiating BI.

Disclosure

R. Mody: Employee; Self; Eli Lilly and Company. Q. Huang: None. M. Yu: Employee; Self; Eli Lilly and Company. Employee; Spouse/Partner; Lifelabs. Stock/Shareholder; Self; Eli Lilly and Company. X. Zhang: None. L. Wang: Employee; Self; HealthCore. Employee; Spouse/Partner; Janssen Pharmaceuticals, Inc. M. Grabner: None. H. Patel: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company.

Funding

Eli Lilly and Company

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.