Study types
Results
Discussion

The treatment of diabetes includes both lifestyle changes and pharmacological therapy. Whilst type 1 diabetes mandates insulin use from the time of diagnosis, the management of type 2 diabetes begins with lifestyle advice. If glycaemic control is inadequate, oral hypoglycaemic medication is added, and insulin is added for those in whom oral therapy is insufficient to achieve glycaemic targets. 

Each drug can be used alone or in a variety of combinations with others. The patterns of use of different therapies within a population can be influenced by many factors including the availability of medication, beliefs among healthcare professionals about the value, efficacy and practicality of different therapies, the phenotype of the person with diabetes (particularly in regard to obesity), and the costs, which include not only the drug cost, but also the costs of associated education for the person with diabetes (specifically with regard to insulin use). 

The data have been collected from a variety of sources, including published articles, government and institution reports, national pharmacy databases and personally communicated information. Searches of Medline were undertaken using the major Medical Subject Headings (MeSH) categories of ‘diabetes mellitus (epidemiology)’, ‘diabetes mellitus (diet therapy)’, ‘diabetes mellitus (drug therapy)’. Further articles were accessed in Medline using ‘related articles’. 

There appears to be a very wide range of prescribing habits across the world. Whilst some of these differences are easily explicable in terms of different prevalences of type 1 and type 2 diabetes, and others are attributable to differences in study methodology, there is a clear need to investigate further how prescribing habits can be brought into closer alignment with treatment guidelines.