OBJECTIVES: Each year, the American Diabetes Association publishes a new version of the "Standards of Care in Diabetes," which includes recommendations for pharmacological approaches to glycemic control in patients with type 2 diabetes. From 2018 to 2019, there was a significant change, making the guideline start considering key patient factors. This study aims to investigate the impact of the 2019 diabetes guideline on the prescription patterns of antidiabetic drugs for patients with type 2 diabetes.

METHODS: Using an interrupted time series analysis method, the authors incorporated pharmacy claims data from Optum for the years 2018 to 2019, encompassing all antidiabetic drugs excluding insulin.

RESULTS: Among the drug classes mentioned in the new guideline for their proven benefits or risks, the quarterly prescription rates of SGLT2 inhibitors increased from 4.7% to 6.3%, GLP-1 receptor agonists rose from 5% to 7.5%, and DPP-4 inhibitors decreased from 9.4% to 8.7%. In contrast, metformin usage consistently declined from 53.8% to 52.6%, with a notably sharp decrease in 2019. Specifically, the prescription rate of empagliflozin increased from 2.13% in 2018 at a rate of 0.28% per quarter to 0.37% in 2019; semaglutide rose from nearly 0% in 2018 at a rate of 0.02% per quarter to a 0.31% growth rate in 2019; metformin declined from 53.96% in 2018 at a rate of 0.12% per quarter and accelerated to a 0.2% decline in 2019.

CONCLUSIONS: In summary, the 2019 diabetes care guidelines appear to have significantly influenced real-world prescribing patterns of antidiabetic drugs for patients with type 2 diabetes, favoring drugs with documented benefits in cardiovascular or renal outcomes while deemphasizing those lacking contemporary evidence from cardiovascular outcome trials.