Diabetes Metab J.  2023 Mar;47(2):211-219. 10.4093/dmj.2022.0346.

Insulin Fact Sheet in Type 1 and 2 Diabetes Mellitus and Trends of Antidiabetic Medication Use in Insulin Users with Type 2 Diabetes Mellitus: 2002 to 2019

• Park J
• Kim G
• Kim BS
• Han KD
• Kwon SY
• Park SH
• Lee YB
• Jin SM
• Kim JH

• KMID: 2540518
• DOI: http://doi.org/10.4093/dmj.2022.0346

Abstract

Background
This study investigated the trends of insulin use among Korean patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Changes in prescription of antidiabetic medications in T2DM patients taking insulin therapy were evaluated.
Methods
We analyzed data from the National Health Insurance Service database in Korea to evaluate the prevalence of insulin users and trends of insulin use in T1DM and T2DM patients from January 2002 to December 2019. We also investigated numbers and types of antidiabetic medications in insulin users with T2DM.
Results
The overall total number of insulin users increased from 2002 to 2019, reaching 348,254 for T2DM and 20,287 for T1DM in 2019 compared with 109,974 for T2DM and 34,972 for T1DM in 2002. The proportion of patients using basal analogs and short acting analogs have increased and those using human insulin, premixed insulin, or biphasic human insulin have decreased (rapid acting analogs: 71.85% and 24.12% in T1DM and T2DM, respectively, in 2019; basal analogs: 76.75% and 75.09% in T1DM and T2DM, respectively, in 2019). The use of other antidiabetic medication in addition to insulin increased for T2DM, especially in dual therapy, reaching up to 52.35% in 2019 compared with 16.72% in 2002.
Conclusion
The proportion of the patients using basal or rapid acting analogs increased among all insulin users in both T1DM and T2DM patients. Among patients with T2DM, the proportion of patients using antidiabetic medications in addition to insulin was significantly increased compared to those who used insulin alone.

Keyword

Diabetes mellitus, type 1; Diabetes mellitus, type 2; Hypoglycemic agents; Insulin

Figure

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  Fig. 1. Trends in insulin prescription in type 2 diabetes mellitus. BHI, biphasic human insulin.

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  Fig. 2. Trends in rapid acting analogs and/or basal analogs use in type 2 diabetes mellitus.

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  Fig. 3. Trends in antidiabetic medications use in addition to insulin in type 2 diabetes mellitus.

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  Fig. 4. Prescription trends in the six most commonly used antidiabetic medication in 2019 from 2002 to 2019. DPP-4i, dipeptidyl peptidase-4 inhibitor; SU, sulfonylurea; SGLT2i, sodium glucose cotransporter 2 inhibitor.

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