# Fifteen-year trends in diabetes drug management and control in French-speaking Switzerland

## TL;DR

This study examines how diabetes drug prescriptions and control have changed over 15 years in French-speaking Switzerland, finding that newer drugs haven't improved control rates significantly.

## Contribution

The study provides the first 15-year analysis of diabetes drug management trends and control effectiveness in French-speaking Switzerland.

## Key findings

- Newer diabetes drugs like SGLT2 and DPP4 inhibitors increased, but did not consistently improve diabetes control.
- Participants newly diagnosed with diabetes had significantly better control than those with established diabetes.
- Over half of participants treated for diabetes did not achieve adequate control despite newer drug prescriptions.

## Abstract

Drug management of type 2 diabetes (T2D) should comply with established guidelines. Still, little is known about how drug management of T2D in Switzerland has evolved over time. We aimed at assessing 15-year trends in antidiabetic drug prescription and its effectiveness in reducing fasting plasma glucose (FPG) levels.

Data from the baseline (2003–2006) and three follow-ups (2009–2012, 2014–2017 and 2018–2021) of a population-based study conducted in Lausanne, Switzerland. Participants treated for T2D were included. At baseline and the follow-ups, participants had their antidiabetic drugs collected, together with their FPG and glycated haemoglobin (HbA1c) levels.

There were 274, 280, 268 and 195 participants treated for T2D at the baseline, first, second and third follow-ups, respectively, of whom 101 (36.9%), 103 (36.8%), 138 (51.5%) and 84 (43.1%) were controlled (FPG < 7 mmol/L). During the study period, the percentage of biguanides remained stable, the percentage of sulfonylureas and thiazolidinediones decreased, and the percentage of SGLT2 and DPP4 inhibitors increased, but no consistent association with T2D control was found. On bivariate and multivariable analysis, participants with newly diagnosed T2D had a higher likelihood of being controlled than participants with established T2D: odds ratio (95% CI) 3.39 (1.89–6.07), 5.41 (2.25-13.0) and 3.47 (1.45–8.31) for the first, second and third follow-ups on multivariable analysis, respectively.

Despite the prescription of novel antidiabetic drugs, half of participants treated for diabetes do not achieve adequate control in Switzerland. Participants with newly diagnosed diabetes achieve much better control than participants with established diabetes.

The online version contains supplementary material available at 10.1186/s13098-025-01620-z.