Utilisation of drugs for diabetes mellitus

This article reviews the data from drug utilisation research on antidiabetic agents, oral hypoglycaemics and insulin. Study methods specific to this type of pharmacoepidemiological research are discussed and critiqued. A brief overview of the sources of drug utilisation data is presented, followed by a review of specific pharmacoepidemiological investigations. We evaluate the usefulness of these studies in assessing true drug consumption, in evaluating comorbidity in diabetic patients and in measuring the prevalence of diabetes. International comparisons of antidiabetic drug utilisation, also reviewed and analysed, demonstrate wide variations in the use of hypoglycaemic agents, which have arisen for reasons which are unclear. Drug utilisation research thus far has been limited by the paucity of studies relating these variations in antidiabetic drug use to specific clinical outcomes. There is a need to expand the applications of research on the use of antidiabetic agents, including assessment of patterns of morbidity across geographic boundaries and over time.