1258-P: Physician Survey on Discontinuing Dipeptidyl Peptidase-4 Inhibitors (DPP-4is) following Insulin Initiation in Patients with Type 2 Diabetes (T2D) in the U.S.

At the time of insulin initiation, physicians often discontinue oral therapies in patients with T2D. A recent randomized clinical trial demonstrated continuing sitagliptin, a DPP-4i, results in a clinically meaningful greater reduction in HbA1c without an increase in hypoglycemia. An online U.S. physician survey (n=400) is being conducted to understand reasons for discontinuation of DPP-4i therapy. Preliminary analysis is based on completed surveys (n=180; 41 endocrinologists, 74 family practice, 63 internal medicine, 2 diabetologists) from physicians treating a monthly average of 137 patients. Table lists key physician characteristics and their responses for continuing/discontinuing DPP-4i on initiation of insulin. The top responses for continuing DPP-4i include meeting treatment goals, using a lower dose of insulin, good tolerability, reducing weight gain and hypoglycemia. The top responses for discontinuing include adverse events/tolerability, cost, treatment goals not being met, patient preference, and prior authorization requirements. In this ongoing study, further data is being collected on the remaining physician sample and a medical chart review will be conducted on a sub-sample of patients treated by these physicians to explore patient characteristics associated with DPP-4i discontinuation. Disclosure G. Fernandes: None. D.H. Jaffe: Consultant; Self; Merck & Co., Inc. G. DiBonaventura Beyer: None. J.E. Matos: None. K. Iglay: Employee; Self; Merck & Co., Inc. Stock/Shareholder; Self; Merck & Co., Inc. I. Gantz: Employee; Self; Merck & Co., Inc. S. Rajpathak: None.