OBJECTIVES: In China, while insulin has been prescribed for decades, glucagon-like peptide 1 receptor agonists (GLP-1-RA) have been available as an injectable treatment for type 2 diabetes mellitus (T2DM) patients since 2009. GLP-1 RAs are listed as 2^nd line treatment in the 2017 Chinese Guideline for T2DM patients who have failed prior oral antidiabetic therapy. This study aimed to compare the baseline characteristics associated with the prescription of first injectable therapy (GLP-1-RA or Insulin) for T2DM adult patients in China.

METHODS: The IQVIA Patient Diary Study database, which captures data from a patient chart-based physician online survey, was the data source used in this study. Cross-sectional patient data were collected from hospitals in 13 major Chinese cities during 06/01/2016 to 06/30/2017. T2DM adult patients commencing either GLP-1-RA or insulin as their first injectable anti-diabetic therapy were included. Baseline demographics and clinical characteristics were compared between the GLP-1-RA and insulin treatment groups, using t-tests and Fisher's exact tests.

RESULTS: Overall, 177 and 1,056 GLP-1-RA and insulin initiators were identified. In general, GLP-1-RA initiators were younger (mean ± sd: 49.3 ± 9.8 years vs. 58.7± 11.0 years), with a shorter time since T2DM diagnosis (4.4±4.2 vs. 6.7±4.2 years), lower HbA1c (8.6%±1.2% vs. 9.7%±1.8%), lower fasting plasma glucose (9.2±1.8 mmol/L vs. 11.0±2.7 mmol/L), higher BMI (30.2±5.8 Kg/mvs. 24.4±3.4 Kg/m), higher comorbidity of obesity (66% vs. 9%) and higher hyperlipidemia (53% vs. 35%) levels, when compared to insulin initiators. All above p values are<.0001.

CONCLUSIONS: Significant differences were identified between selected baseline characteristics of patients initiating GLP-1-RA and insulin therapy, suggesting that these medicines are more likely to be prescribed to different types of T2DM patients in China. These findings may help to inform Chinese physicians regarding the characteristics of those T2DM patients who are initiating on a GLP-1 RA or insulin therapy.