Longer medication persistence in type 2 diabetes (T2D) is associated with improved glycaemic control. It is not clear which oral therapies have the best persistence. The objective of this study was to compare medication persistence across different oral therapies in people with T2D.
We performed a retrospective cohort analysis using a primary-care-based population, the Royal College of General Practitioners Research and Surveillance Centre cohort. We identified new prescriptions for oral diabetes medication in people with type 2 diabetes between January 1, 2004 and July 31, 2015. We compared median persistence across each class. We also compared non-persistence (defined as a prescription gap of ≥ 90 days) between classes, adjusting for confounders, using Cox regression. Confounders included: age, gender, ethnicity, socioeconomic status, alcohol use, smoking status, glycaemic control, diabetes duration, diabetes complications, comorbidities, and number of previous and concurrent diabetes medications.
We identified 60,327 adults with T2D. The majority 42,810 (70.9%) of those had one or more oral medications prescribed; we measured persistence in those patients (who were prescribed 55,728 oral medications in total). Metformin had the longest median persistence (3.04 years; 95% CI 2.94-3.12). The adjusted hazard ratios for non-persistence compared with metformin were: sulfonylureas HR 1.20 (1.16-1.24), DPP-4 inhibitors HR 1.43 (1.38-1.49), thiazolidinediones HR 1.71 (95% CI 1.64-1.77), SGLT2 inhibitors HR 1.04 (0.93-1.17), meglitinides HR 2.25 (1.97-2.58), and alpha-glucosidase inhibitors HR 2.45 (1.98-3.02). The analysis of SGLT2 inhibitors was limited by the short duration of follow-up for this new class. Other factors associated with reduced medication persistence were female gender, younger age, and non-white ethnicity.
Persistence is strongly influenced by medication class and should be considered when initiating treatments.
Pharmacology, Toxicology and Pharmaceutical Science
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7%
Nursing and Health Professions
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Social Sciences
4
3%
Computer Science
3
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Other
9
7%
Unknown
69
56%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 75. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 June 2025.
All research outputs
#659,473
of 29,485,101 outputs
Outputs from Diabetes Therapy
#29
of 1,392 outputs
Outputs of similar age
#13,154
of 465,177 outputs
Outputs of similar age from Diabetes Therapy
#2
of 30 outputs
Altmetric has tracked 29,485,101 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,392 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.1. This one has done particularly well, scoring higher than 97% of its peers.
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We're also able to compare this research output to 30 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.
