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Instituto Nacional de Salud Pública

2025, Number 5

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salud publica mex 2025; 67 (5)

Impact of new glucose-lowering drugs and quality of care among employees with diabetes

Ortiz-Brizuela E, Vera-Zertuche JM, Gutiérrez-Díaz H, Domínguez-Zárate H, Krug-Llamas E, Arizmendi-Uribe E, Vázquez-Espinoza C, Basilio-Lara LA, De Lucio-Ortega AJ, Pedrero-Moreno H, Vieyra-Romero W, Hernández-Ávila M

Language: Spanish
References: 39
Page: 494-505
PDF size: 386.41 Kb.


ABSTRACT

Objective. To assess the impact of new glucose-lowering medications and identify opportunities to improve the quality of care for workers with diabetes mellitus (DM) receiving oral treatment and uninterrupted social security coverage. Materials and methods. Retrospective cohort study (2021-2023). We analyzed changes in HbA1c and plasma glucose following the addition of new glucose-lowering medications to metformin monotherapy using a differencesin- differences approach. We also evaluated the frequency of follow-up testing, achievement of therapeutic goals, and consistency of treatment dispensing in this population. Results. Of 297 929 workers with DM receiving oral treatment and continuous social security coverage, 57.5% (171 408) remained on metformin monotherapy or added a second medication during the study period. Of these, only 2.6% (4 502) and 12.1% (20 791) had pre- and post-intervention HbA1c and plasma glucose measurements, respectively. The use of iSGLT2 was associated with a reduction of 0.6 percentage points in HbA1c (95%CI: -0.7,-0.4) and 14.1 mg/dL in glucose (-16.6,-11.5). The use of iDPP-4 was associated with a reduction of 0.6 percentage points in HbA1c (-0.7,-0.5) and 16.6 mg/dL in glucose (-18.1,-15.1). Finally, the use of arGLP-1 was associated with a reduction of 0.3 percentage points in HbA1c (-0.7,0.02) and 12.5 mg/dL in glucose (-18.2,-6.8). Conclusion. The use of the new glucose-lowering medications was associated with improved glycemic control in this population. Several areas for improvement were identified regarding the quality of care, including the low frequency of laboratory follow-up.


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