OBJECTIVE Type 2 diabetes often coexists with other conditions that are amenable to pharmacological treatment. We hypothesized that polypharmacy among individuals with type 2 diabetes has increased since 2000. RESEARCH DESIGN AND METHODS Using Danish national registries, we established a cohort of all Danish individuals (aged ≥18 years) with type 2 diabetes between 2000 and 2020. We analyzed their medication use and prevalence of varying degrees of polypharmacy (≥5 or ≥10 medications), stratifying by age, sex, number of chronic diseases, and socioeconomic status. RESULTS The cohort grew from 84,917 patients in 2000 to 307,011 in 2020, totaling 461,849 unique patients. The number of daily medications used per patient increased from (mean ± SD) 3.7 ± 2.8 (in 2000) to 5.3 ± 3.2 (in 2020). The lifetime risk of polypharmacy was substantial, with 89% (n = 409,062 of 461,849) being exposed to ≥5 medications at some point and 47% (n = 217,467of 461,849) to ≥10 medications. The increases were driven by an expanding group of medications, with analgesics, antihypertensives, proton pump inhibitors, and statins having the largest net increase. Advanced age, male sex, lower socioeconomic status, and Danish ethnicity positively correlated with polypharmacy but could not explain the overall increase in polypharmacy. CONCLUSIONS Medication use and polypharmacy have increased among patients with type 2 diabetes. Although the implications and appropriateness of this increased medication use are uncertain, the results stress the increasing need for health care personnel to understand the potential risks associated with polypharmacy, including medication interactions, adverse effects, and over- and underprescribing.

中文翻译：

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增加 2 型糖尿病的药物使用和联合用药：2000 年至 2020 年丹麦的经验

目的 2 型糖尿病通常与其他适合药物治疗的疾病并存。我们假设自 2000 年以来 2 型糖尿病患者的多重用药有所增加。 研究设计和方法 利用丹麦国家登记处，我们建立了 2000 年至 2020 年间所有丹麦 2 型糖尿病患者（年龄≥18 岁）的队列。我们分析了他们的不同程度的多重用药（≥5种或≥10种药物）的药物使用和患病率，按年龄、性别、慢性病数量和社会经济状况分层。结果 该队列从 2000 年的 84,917 名患者增加到 2020 年的 307,011 名患者，总计 461,849 名独特患者。每名患者每日使用的药物数量从（平均值±标准差）3.7±2.8（2000年）增加到5.3±3.2（2020年）。多重用药的终生风险很大，其中 89%（n = 461,849 人中的 409,062 人）在某个时刻接触过 ≥5 种药物，47%（n = 461,849 人中的 217,467 人）接触过 ≥10 种药物。这一增长是由不断扩大的药物类别推动的，其中镇痛药、抗高血压药、质子泵抑制剂和他汀类药物的净增长最大。高龄、男性、较低的社会经济地位和丹麦种族与多重用药呈正相关，但无法解释多重用药的总体增加。结论 2 型糖尿病患者的药物使用和多重用药有所增加。尽管药物使用增加的影响和适当性尚不确定，但结果强调，医疗保健人员越来越需要了解与多种药物相关的潜在风险，包括药物相互作用、不良反应以及处方过量和不足。