No increase in new users of blood glucose-lowering drugs in Norway 2006-2011: a nationwide prescription database study

Abstract

Background: National estimates for the occurrence of diabetes are difficult to obtain, particularly time trends in incidence. The aim was to describe time trends in prevalent and incident use of blood glucose-lowering drugs by age group and gender in Norway during 2005-2011.

Methods: Data were obtained from the nationwide Norwegian Prescription Database. We defined prevalent users of "insulins only" as individuals having no oral antidiabetic drugs (OAD) dispensed from a pharmacy during the previous 24 months or in the subsequent 12 months. Incident users had no blood glucose-lowering drugs dispensed in the previous 24 months; incident "insulins only" users also had no OAD in the subsequent 12 months.

Results: In 2011, 3.2% of the population had blood glucose-lowering drugs dispensed, and the incidence rate was 313 per 100,000 person years. The prevalence of OAD use increased from 1.8% in 2005 to 2.4% in 2011; however a decreasing trend in incidence of OAD use was observed, particularly in those aged 70 years and older. In 2010, 0.64% of the population had insulins only dispensed, with an overall incidence rate in the total population of 33 per 100,000 person years which was stable over time.

Conclusions: In this nationwide study, we found that although the prevalent use of OAD had increased in recent years, incident use was stable or had decreased. This may indicate that the increase in diabetes occurrence in Norway is levelling off, at least temporarily.

Figure 1

Flow chart illustrating the definitions used for classifying subjects as (a) prevalent and (b) incident users of any blood glucose-lowering drug, OAD and insulins only. Figures for 2010 are shown.

Figure 2

Prevalent use of blood glucose-lowering drugs by age and gender in Norway in 2010. Solid lines: any blood glucose-lowering drug (A10). Dashed lines, oral antidiabetic drugs. Short dashed lines: insulins only; i.e. individuals having insulins dispensed in 2010, but no OAD in the previous 24 months or in the subsequent 12 months after the first prescription filled.

Figure 3

Time trends in prevalence of OAD (A10B) use by 10 year age groups in (a) men and (b) women.

Figure 4

Incident use of blood glucose-lowering drugs by age and gender in Norway. Incident use is defined as no use of blood glucose-lowering drugs in the previous 24 months. (a) OAD (A10B); period 2006–2011. (b) Insulins and analogues (A10A); period 2006–2010. No OAD dispensed in the subsequent 12 months.

Figure 5

Time trends in incident use of blood glucose-lowering drugs in Norway. Incident defined as no use of blood glucose-lowering drugs in the previous 24 months. In addition for incident use of insulins only, no OAD dispensed in the subsequent 12 months. (a) Incident use of OAD (A10B) in men (b) Incident use of OAD in women. (c) Incident use of insulins only (A10A) in men (d) Incident use of insulins only in women.