Physician Reported Reasons for discontinuing or down-Titrating Sulfonylureas In type 2 Diabetes Patients

Sulfonylureas (SU) are a widely-prescribed class of oral medications used to treat type 2 diabetes mellitus and are known to cause hypoglycemic events (HE) and weight gain. In this survey, we aimed to identify reasons reported by physicians for discontinuing (DC) or down-titrating (DT) SU therapy. Primary care physicians (PCPs) and specialists (endocrinologists and diabetologists) were recruited from the AllGlobal panel, an actively managed, double opt-in panel of physicians. Participants were asked to rate their level of concern regarding potential reasons for DC or DT on a 7-point Likert scale (1=not at all concerned, 7=extremely concerned). In addition, physicians reviewed one chart each from a typical SU patient with DC or DT in the previous 6 months and 2 current SU patients without DC or DT in the previous 6 months to collect patient characteristics and medical history. 776 PCPs and 250 specialists participated, of whom 76% were male and 93% were aged 35 to 64. Physicians reported highest concern about HE requiring medical assistance (DC=6.0, DT=5.9), HE requiring non-medical assistance (DC=5.9, DT=5.9), other HE not requiring assistance (DT=5.7), and treatment goals not being met (DC=5.6). Compared to current users, DT and DC patients were more likely to have experienced ≥1 HE in the previous year (DC=41.0%, DT=43.1% vs. current=8.8%; p