OBJECTIVES: Diabetes mellitus (DM) is a chronic disease associated with one of the biggest health burden. It is estimated that the prevalence will further increase. The burden of DM can be even higher caused by irrational prescribing. Thus, we aimed to perform an analysis of prescribing patterns of antidiabetic drugs in Slovenia.

METHODS: The nationwide health claims data on prescription drugs, provided by national Health Insurance Institute of Slovenia, was used. The study period between 2008 and 2015 was selected, as new classes of antidiabetic medicines entered the market; namely, dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor (GLP-1) agonists, and sodium/glucose cotransporter 2 (SGLT2) inhibitors.

RESULTS: The prevalence of DM treated with medicines in Slovenia increased from 4.1% in 2008 to 5.1% in 2015, with an average rate of 3.4% per year. In the study period, 45% of the treated patients received only one type of medicines, 30% of the patients received medicines from two different classes, additional 15% of patients received 3 different classes of antidiabetic medicines. Among the patients, who received only one type of the medicines, the majority received metformin (45%), followed by insulins (28%), and sulfonylureas (20%). The most frequent combination was metformin and sulfonylureas, represents 62% of cases with two types of antidiabetic medicines, followed by combinations with insulins in 24% of such patients. New classes of antidiabetic medicines received 0.4%, 6%, and 8% of the treated patients in 2008, 2012, and 2015, respectively. The most prevalent were DPP-4 inhibitors (presented from 2008), while GLP-1 agonists and SGLT2 inhibitors were introduced in Slovenia in 2009 and 2014, respectively. However, more than 99% of patients received also other classes, 48% metformin, 33% sulfonylureas, and 11% insulins.

CONCLUSIONS: The prescribing of new classes of antidiabetic medicines is relatively low, while the insulins are relatively frequently prescribed.