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Abstract: FR-PO258

Temporal Trends in Pharmacologic Management of Diabetes Mellitus Among Patients with CKD in the United States

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Murphy, Daniel P., University of Minnesota, Minneapolis, Minnesota, United States
  • Foley, Robert N., University of Minnesota, Minneapolis, Minnesota, United States
Background

The nexus of diabetes mellitus and chronic kidney disease (DM-CKD) constitutes a major public health problem. Though substantial therapeutic advances have occurred in the last decade, diabetes management patterns in the US DM-CKD population remain poorly delineated. Hence, we examined trends in anti-diabetic medication use among adult National Health and Nutrition Examination Survey participants from years 2001 to 2016.

Methods

Eligible participants had self-reported diabetes or HbA1c ≥ 7.0 % and creatinine-based estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or urinary albumin to creatinine ratio (ACR) ≥ 30 mg/g.

Results

Increases were observed in the proportions taking at least 1 anti-diabetic medication (1+ADM, 73.1% in 2001-2004, 79.2% in 2005-2008, 81.8% in 2009-2012 and 81.9% in 2013-2016, P=0.024). A biphasic pattern was observed for 2+ADM (33.6%, 43.7%, 42.0%, 31.9%, P=0.002). Regarding individual classes of ADM, values rose for biguanides (32.8%, 40.0%, 39.5%, 45%, P=0.048), insulin (26.9%, 27.8%, 38.7%, 39.4%, P=0.001) and meglitinides (0%, 3.5 %, 8.8%, 9.1%, P < 0.001); fell for sulphonylureas (35.9%, 38.3%, 37.1%, 23.6%, P < 0.001) and thiazolidinediones (19.2%, 21.1%, 9.8%, 3.6%, P < 0.001); exhibited a rise-and-fall pattern for alpha-glucosidase inhibitors (0.2%, 1.9%, 0.7% and 0.1%, P=0.015) and amylin analogs (0%, 1.9%, 0%, 0%, P=0.005) and remained statistically unchanged for dipeptidyl peptidase-4 inhibitors (6.5%, 6.5%, 4.5%, 3.7%, P=0.333) and SGLT-2 inhibitors 0%, 0.9%, 1.2% and 2.4%, P=0.091).

Conclusion

Thus, anti-diabetic medication use in the US DM-CKD populations has changed considerably between 2001 and 2016.