Table of Contents
International Journal of Family Medicine
Volume 2016 (2016), Article ID 9837496, 9 pages
Research Article

Ten-Year Trends in the Morbidity of Diabetes Mellitus and Antidiabetic Drug Utilization in Croatia: A Study Based on Routinely Collected Data

1Family Practice “Dr. Renata Pavlov”, Aleja lipa 2a, 10000 Zagreb, Croatia
2Family Practice “Dr. Ivančica Topličan”, Aleja lipa 2a, 10000 Zagreb, Croatia
3Foundation for the Development of Family Medicine in Croatia, Cresnjevec 32, 10000 Zagreb, Croatia

Received 31 October 2015; Revised 19 May 2016; Accepted 24 May 2016

Academic Editor: Hakan Yaman

Copyright © 2016 Renata Pavlov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To investigate trends of diabetes mellitus (DM) morbidity and antidiabetic drug utilization in Croatian primary health care (PHC) from 2005 to 2014. Method. Routinely collected morbidity data from all PHC units, presented in Croatian health-statistics yearbooks, were retrieved. Data on drug utilization were retrieved from the Annual Reports of the Croatian Agency for Medicinal Products and Medical Devices (ATC/DDD, antidiabetic, A10). Results. Total morbidity increased by 33.3% and DM increased by 65.6%, mostly in patients over age 65 (from 50% to 57%). Estimated DM prevalence in adults increased from 3.9% to 6.4%. Increased morbidity was followed by an even higher increase in drug utilization (120%). Metformin was first, with a constant increase (from 18% to 39%), followed by glimepiride, while glibenclamide use decreased. Total utilization of insulin increased even more, mostly for aspart (600%) and newly introduced glargine and detemir, while human insulin usage sharply decreased. Spending also increased, mostly for aspart (from 21% to 61% of total). Conclusions. Increased DM is followed by a higher increase in antidiabetic drug utilization; this trend will continue in the future. In Croatian PHC, metformin has primacy along with insulin analogues.