Impact of the COVID-19 pandemic on antidiabetic drugs initiation in Sweden, an interrupted time series study

AimTo investigate the impact of the COVID-19-pandemic on antidiabetic drug initiation MethodsUsing Swedish national health registers, an interrupted time series study for all first-time dispensed antidiabetic drugs was performed. A minimum 14-month washout period was used. We calculated monthly cumulative incidence of antidiabetic drug initiations per 1000 population and estimated trends before and after the onset of the pandemic using segmented regression analysis. ResultsAmong 167,889 participants between 1Mar2019 and 30Nov2021, male sex (53%), age 18-64 (55.3%), unmarried status (52.5%), upper secondary education level (46.2%), and being employed (53.5%) were the most frequent characteristics. Mar2020, there was an immediate level drop in antidiabetic drug initiation ({beta}2=-0.087%, P=0.01); however, the trend exhibited a rapid increase thereafter. Significant immediate level drops were identified for DPP4i (-0.087%, P=0.01), GLP1a (-0.008%, P=0.01) and SGLT2i (-0.033%, P=0.003). Older people ([≥]65) showed the largest immediate drop for antidiabetic drug initiation (-0.272%, P=0.003). SGLT2i demonstrated an increasing pattern both before and after the pandemic while metformin did reveal an increasing pattern among patients [≥]65 years old after the pandemic. ConclusionThe results identified an immediate level drop at the onset of the pandemic for any antidiabetic drug initiation, but the trend increased rapidly thereafter.