OBJECTIVES: To describe the changing patterns in the use of the various classes of antidiabetic drugs in a cohort of patients newly treated for diabetes from 2008 to 2015.

METHODS: General scheme beneficiaries 45 years and older were identified in the French National Health Data System (SNDS) as newly treated when antidiabetic drugs were dispensed on at least 3 different dates in 2008 and at least once during the last 4 months of 2008, but were dispensed less than 3 times in 2006-2007.

RESULTS: The proportion of patients taking monotherapy decreased by 13 percentage points during the second year and only 32% of the cohort was treated by monotherapy 8 years after starting treatment. The proportions of patients taking dual therapy increased by 4 percentage points (21% in 2015), triple therapy increased by 8 percentage points (11%), a combination of insulin + other antidiabetics increased by 4 percentage points (7%) and insulin alone remained stable (4%).

The proportion of patients taking metformin monotherapy increased slightly (67% in 2008, +2 percentage points).

At the last quarter of 2015, 12% of patients did not receive any antidiabetic drugs and 13% had died.

The creation of a cohort of diabetic patients newly treated in 2013 demonstrated changing prescribing practices: a lower proportion of monotherapy in the first year of treatment, but a growing use of metformin.

CONCLUSIONS: Initiation of antidiabetic drug therapy in people 45 years and older consisted of monotherapy in 3/4 of cases in 2008. Treatment was intensified during the first 8 years for one half of the cohort. Insufficient use of Metformin, in general and in terms of dosage, was observed, although this use is improving.