{"id":"5c8b03a7a881","type":"article","url":"https://hartvaat.nl/2026/10/24/sglt2-remmers-en-statinen-verbeteren-metabole-controle-bij-diabetes-type-2-real-/","title":"SGLT2-remmers en statinen verbeteren metabole controle bij diabetes type 2 — real-world trends","title_en":"Trends in metabolic risk factor control and medication use among adults with type 2 diabetes in Taiwan, 2015-2024.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Journal of the Formosan Medical Association = Taiwan yi zhi","doi":"10.1016/j.jfma.2026.10.030","source_url":"https://doi.org/10.1016/j.jfma.2026.10.030","authors":["Pei-Li Li","Yen-Chieh Lee","Li-Chiu Wu","Jou-Wei Lin","Chia-Hsuin Chang"],"significance":5,"published":"2026-11-01","source_date":"2026-10-24","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"A 10-year trend analysis of Taiwan’s national health insurance database (2015–2024) evaluated metabolic control and pharmacotherapy in 2.27 million adults with type 2 diabetes. Target achievement improved significantly, with HbA1c <7.0% rising from 42.5% to 55.3% and LDL-C <100 mg/dL from 54.3% to 69.0%, driven largely by increased SGLT2 inhibitor and statin uptake. These real-world data demonstrate that guideline-directed cardiorenal therapies are improving metabolic outcomes, but highlight persistent gaps that require risk-stratified management strategies in primary and specialist care.","created":"2026-10-26T02:20:48Z","updated":"2026-10-26T02:20:48Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een analyse van het Taiwanse zorgdatabestand (2015–2024) toont de ontwikkeling van metabole controle en medicatiegebruik bij 2,27 miljoen volwassenen met diabetes type 2. Het percentage patiënten met een HbA1c <7,0% steeg van 42,5% naar 55,3% en LDL-C <100 mg/dL van 54,3% naar 69,0%, mede door de sterke toename van SGLT2-remmers (van 3,3% naar 38,0%) en statinen. De resultaten illustreren dat de invoering van cardiorenale medicatie de real-world controle verbetert, maar onderstrepen de behoefte aan gerichte, risicogestratificeerde zorg voor jongere patiënten en hoogrisicogroepen.","abstract_original":"BACKGROUND: To evaluate 10-year trends in metabolic control and guideline-directed pharmacotherapy among adults with type 2 diabetes in Taiwan. METHODS: Using Taiwan's National Health Insurance Research Database (2015-2024), we analyzed annual trends in glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), and medication use. Blood pressure (BP) was assessed via a nationwide Pay-for-Performance registry. Trends were evaluated overall and across subgroups with cardiovascular disease (CVD) or chronic kidney disease (CKD). RESULTS: The treated population expanded from 1.58 to 2.27 million. Target achievement improved significantly: HbA1c <7.0% rose from 42.5% to 55.3%, and LDL-C <100 mg/dL from 54.3% to 69.0% (both p-trend <0.001). Among patients with all three measurements available, triple-factor control reached 18.2% by 2024. These gains coincided with rapid sodium-glucose cotransporter-2 inhibitor (SGLT2i) uptake (from 3.3% in 2016 to 38.0% in 2024) and increased statin use. However, 23.5% of young adults (20-44 years) maintained poor glycemic control (HbA1c ≥ 8.5%). SGLT2i use was higher in patients with CVD (43.1%) or CKD (43.8%) than in those without the respective conditions (34.7% and 36.6%), while glucagon-like peptide-1 receptor agonist (GLP-1RA) use remained below 4%. CONCLUSIONS: Metabolic control in Taiwan improved substantially alongside adoption of newer therapies. Gaps among younger adults and high-risk cohorts highlight the need for targeted, risk-stratified management."}