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Clin Epidemiol. 2016 Oct 14;8:381-387. eCollection 2016.

Nationwide trends in glucose-lowering drug use, Denmark, 1999-2014.

Author information

Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.
Department of Pharmacology, University of Aarhus, Aarhus, Denmark; Department of Endocrinology, Gentofte University Hospital, Copenhagen, Denmark.



The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014.


Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes.


The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1,000 in 2014 (n=233,230). Metformin use increased more than sevenfold during the period and was used by 30 of 1,000 inhabitants in 2014, while the prevalence of insulin use increased 1.8-fold to 13 per 1,000 in 2014. After peaking in 2007, use of sulfonylurea halved to 6 per 1,000 in 2014. Newer drug classes including the glucagon-like peptide 1 receptor agonists, the dipeptidylpeptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors had reached a considerable position by 2014, with 4 per 1,000, 6 per 1,000, and 0.8 per 1,000 inhabitants, respectively; however, the use of glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors in elderly people remained low. Thiazolidinediones decreased to virtually no use (0.03 per 1,000) in 2014.


The use of glucose-lowering drugs has doubled during 1999-2014. The pattern of glucose-lowering drug use has changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received.


antidiabetic drugs; diabetes mellitus; drug utilization; registries

Conflict of interest statement

The authors report no conflicts of interest in this work. The Department of Clinical Epidemiology, Aarhus University Hospital, is a member of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) (Danish Research Council, grants 09-075724 and 10-079102). DD2 is also supported by the Danish Health and Medicines Authority, the Danish Diabetes Association, and an unrestricted donation from Novo Nordisk A/S. Partners in the DD2 project are listed on the project website at The Department of Clinical Epidemiology, Aarhus University Hospital participates in the International Diabetic Neuropathy Consortium (IDNC) research program, which is supported by a Novo Nordisk Foundation Challenge program grant (grant number NNF14SA0006). The Department of Clinical Epidemiology, Aarhus University Hospital receives funding for other studies from companies in the form of research grants to (and administered by) Aarhus University. None of these studies have any relation to the present study.

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