Patients with type 2 diabetes are treated with many drugs other than insulin. In 2014, Medicare paid 58 million claims for noninsulin diabetes drugs. Most of these claims were for agents that have been used for many years: 53% were for metformin, the consensus first-line drug; 30% for sulfonylureas; and 5% for thiazolidinediones. Almost all other claims were for drugs approved since 2005: dipeptidyl peptidase-4 (DPP-4) inhibitors (13%), glucagon-like peptide 1 (GLP-1) receptor agonists (2%), and sodium-glucose cotransporter 2 (SGLT-2) inhibitors (1%).1 These drug classes are recommended for second-line use after metformin.2
Flory J. Will Cardiovascular Outcomes Data on Newer Diabetes Drugs Bury the Older Agents? JAMA Intern Med. 2017;177(3):301–302. doi:10.1001/jamainternmed.2016.8284
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