(077) Trends in use of diabetes drugs in Sweden 1977–2022: A cross-sectional study

Background: Globally, there has been a dramatic increase in the prevalence of Type 2 Diabetes (T2D) in recent decades, as a result of the rising incidences of obesity and a lack of physical activity. Increasing data suggests that anti-diabetic medications (ADMs) lower the incidence of long-term complications, hospitalizations, and mortality among T2D patients.

Objectives: This study aimed to examine long-term trends in the consumption of T2D medications in Sweden from 1977 to 2022 by utilizing data from national registries and sales statistics.

Methods: A repeated cross-sectional analysis using aggregated sales statistics and individual data (Swedish National Board of Health and Welfare and National Prescribed Drug Register). This trial included all diabetic medications except insulin (A10A) for T2D diabetes medication users over the age of 40. Measures used were period prevalence (patients/1000 inhabitants) and number of Defined Daily Doses/1000 inhabitants (DDD/TID).

Results: The study found an increase of ADMs between 2006 and 2022, also metformin use rose from 1 DDD/TID in 1977 to 14 in 2007. Notably, the incidence of diabetes among individuals aged 40 and above rose from 63.5 patients per 1000 individuals (6.35%) in 2006 to 109.2 patients per 1000 individuals (10.92%) in 2022. Moreover, SGLT-2 inhibitors as a novel class of ADM have shown significant market growth in recent years. In more detail, the number of patients aged 40–79 who used SGLT-2 inhibitors and another class, GLP-1 analogues, increased recently. Sulfonylurea use fell in all ages, but DPP-4 inhibitor utilization increased, particularly in the elderly. The utilization of SGLT-2 inhibitors experienced a significant surge in recent years, rising from 0.3 patients per 1000 inhabitants (0.03% of the population) in 2013 to 60.58 patients per 1000 inhabitants (6.1%) in 2022.

Conclusions: Together, there has been a rise in the utilization of new ADMs in recent years, such as metformin, which has resulted in a decrease in the utilization of conventional medications. Lastly, new reports indicate that SGLT-2 inhibitors not only lower glucose levels, yet they have also been shown in many studies to protect against cardiovascular disease and renal damage in people with T2D. Consequently, there has been a rise in the use of SGLT-2 inhibitors in T2D patients.