(065) Relationship between Anti-diabetic Medication Use and Glycaemic Control in an Asian Cohort with Diabetes in Singapore

Background: Diabetes mellitus (DM) is an increasingly common chronic disease that can lead to a host of severe complications if left uncontrolled. However, utilization data of antidiabetic medications and their effects in Singapore is outdated and limited to small sample sizes.

Objectives: The aim of this study was to determine the association between DM medication use and glycaemic control.

Methods: This was a retrospective diabetes registry-based cohort study. Patients aged 18 and above with incident DM in the SingHealth Diabetes Registry (SDR) from 2013 to 2020 were included. The entire study period included 1 year of baseline period, 1 year of observation period, and 3 months of outcome period. Drug use was measured using the proportion of days covered (PDC) and the changes in HbA1c between the outcome and baseline periods were assessed. The associations between baseline HbA1c and PDC≥0.80, and between PDC and change in HbA1c were analyzed using logistic regression and the Kruskal-Wallis test, respectively.

Results: Of 184,646 unique patients in the SDR from 2013 to 2020, 36,314 met the inclusion and exclusion criteria and were included in the analysis. The median PDC for any DM drug, oral DM drugs, and insulin during the observation period were 20.3%, 16.8%, and 0%, respectively. Those who had good glycaemic control at baseline were less likely to receive DM drugs, and those with poor baseline glycaemic control or missing baseline HbA1c were more likely to be consistent users (PDC>80%) (p < 2.2 x 10-16). Higher PDC for any DM drug and oral DM drugs during the observation period was significantly associated with a negative HbA1c change in a dose-dependent fashion (p < 2.2 x 10-16).

Conclusions: DM Medication use was associated with baseline glycemic control and medication adherence was significantly associated with HbA1c improvements in a dose-dependent fashion.