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. 2025 Jun 17;13(6):1491.
doi: 10.3390/biomedicines13061491.

Prescribing Antidiabetic Medications Among GPs in Croatia-A Real-Life Cross-Sectional Study

Tomislav Kurevija  1   2 , Ema Schönberger  1   3 , Matea Matić Ličanin  1 , Ines Bilić-Ćurčić  1   3 , Ljiljana Trtica-Majnarić  1 , Silvija Canecki-Varžić  1   3
Affiliations

Prescribing Antidiabetic Medications Among GPs in Croatia-A Real-Life Cross-Sectional Study

Tomislav Kurevija et al. Biomedicines. .

Abstract

Background: Advances in the treatment of type 2 diabetes (T2D) in recent decades have been primarily focused on its broader understanding in the context of the possibility of preventing the development and progression of the disease and of cardiovascular (CV) complications. Nevertheless, worldwide research indicates that individuals with T2D are still under-regulated, both in terms of glycemic control and in preventing CV complications. The aim of this study was to examine Croatian general practitioners (GPs)' practice and patterns in prescribing antidiabetic medications and their understanding of guidelines. Methods: Research was conducted using a self-designed anonymous survey, which was delivered to the e-mail addresses of GPs throughout Croatia in digital format. Respondents were solely GPs, without any restrictions with regard to their characteristics. Data on the number of individuals diagnosed with T2D and prescribed a specific medication were based on declarations by respondents from their e-health records. Results: Approximately 59% of individuals with T2D are cared for solely by GPs. In terms of achieving targeted values of HbA1c, 47% of individuals with T2D are well regulated. Almost all the respondents claim that they review prescribed T2D therapy at least once a year. A total of 47.6% of respondents have read and entirely understood the EASD/ADA guidelines, but 58.3% apply the dual principles of controlling HbA1c levels and CV risk in the treatment of T2D. In individuals with associated CV comorbidity, SGLT2ins were the most frequently prescribed. Conclusions: The results indicate that Croatian GPs are still inclined to apply outdated paradigms of T2D treatment but that they are gradually accepting new regimens of care and recommendations for prescribing novel, more effective medications.

Keywords: GLP-1 RAs; SGLT2ins; cardiovascular risk; family medicine; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Data flow diagram representing respondents’ engagement in the study.
Figure 2
Figure 2
Relationship between national health data and the obtained results.
Figure 3
Figure 3
Therapy evaluation frequency in individuals with T2D.
Figure 4
Figure 4
Individuals with T2D whose therapy is changed more frequently.
Figure 5
Figure 5
The most prescribed medications for individuals with T2D and associated comorbidities.
Figure 6
Figure 6
The proportion of specialist engagement in the treatment of individuals with T2D covered by this study. Respondents were asked to declare, based on their practice of referral to a specialist, to estimate the number of T2D cases for which they seek specialist consultation.
Figure 7
Figure 7
The stage of T2D when specialists were involved.
Figure 8
Figure 8
The most common priority indications for the referral of individuals with T2D to a specialist (Likert grade 5).
Figure 9
Figure 9
The proportion of individuals with well-controlled T2D in terms of achieving the target HbA1c level.
Figure 10
Figure 10
The proportion of simultaneously considering achieving targeted HbA1c levels and CV protection with cardio- and reno-protective medications in T2D cases.
Figure 11
Figure 11
Factors used to determine satisfactory target values of HbA1c.
Figure 12
Figure 12
Factors that an individualized treatment approach for individuals with T2D should include.
Figure 13
Figure 13
Familiarity with EASD/ADA guidelines for T2D treatment and for prescribing SGLT2ins and GLP-1 RAs.
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