A National Physician Survey Examining Switching from Sulfonylureas or Insulin to Newer Diabetes Medications

This study was a national survey of U.S. physicians in general medicine, geriatrics, or endocrinology who were asked what medication change they would make for adults with type 2 diabetes taking sulfonylureas or insulin with an A1C below their individualized goal. Responding physicians switched the hypoglycemia-causing medication a median of 4 times (interquartile range 1–9) among 27 opportunities and selected dipeptidyl peptidase 4 inhibitors most often when switching. Sodium–glucose cotransporter 2 inhibitors were selected less frequently, including when indicated for cardiovascular and renal comorbidities, but significantly more often among physicians caring for a greater proportion of patients with private health insurance. Overcoming barriers to switching hypoglycemia-causing medications may help to reduce rates of hypoglycemia while targeting cardiovascular and renal comorbidities.