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Japan's Diabetes Prescribing Trends Show GLP-1 and SGLT2 Drug Use Rising, Older Drugs Declining

RPEP-147772026Aoyama, Kazuki; Okada, Akira; Kaneko, Hidehiro; Azegami, Tatsuhiko; Suzuki, Yuta; Meguro, Shu; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Node, Koichi; Yamauchi, Toshimasa; Nangaku, Masaomi; Takeda, Norihiko; Yasunaga, Hideo; Hayashi, Kaori
evidence
The takeaway

A nationwide Japanese claims database analysis shows rapidly increasing GLP-1 RA and SGLT2i prescribing while older drug classes decline, with patterns varying by age, BMI, and kidney function.

Rapidly increasing

GLP-1 RA and SGLT2i prescribing rising in Japan 2015-2024 across all patient subgroups

What the researchers found

GLP-1 RA and SGLT2i prescribing in Japan is rising rapidly, with prescribing patterns increasingly differentiated by patient characteristics like age, BMI, and kidney function.

Why it matters

Tracking prescribing trends reveals how quickly evidence from clinical trials translates into practice and whether medications reach the patients who benefit most.

How the study worked

Retrospective analysis of a large-scale Japanese claims database (2015-2024); prescription rates assessed by drug class, stratified by multiple patient characteristics.

What this study cannot tell us

Claims database — captures prescriptions but not adherence or clinical outcomes; Japanese prescribing patterns may not generalize to other healthcare systems.

How to read the evidence

Retrospective database analysis — provides robust prescribing trend data but no clinical outcome assessment.

When this study was published

Published 2026 in Diabetes, Obesity & Metabolism. Data through 2024.

The bigger picture

Japan's prescribing evolution mirrors a global shift toward individualized diabetes care, driven by cardiovascular and renal outcome trial data for newer drug classes.

Questions still open

  • Are the right patients receiving GLP-1 RAs and SGLT2i based on their risk profiles?
  • How does Japan's uptake compare to other high-income countries?

Common questions

Are newer diabetes drugs replacing older ones?
Yes — in Japan, prescriptions for GLP-1 drugs and SGLT2 inhibitors are rising rapidly while older medications like sulfonylureas are declining, reflecting updated clinical evidence.
Do doctors prescribe different diabetes drugs based on patient characteristics?
Increasingly yes — this study found prescribing patterns vary significantly based on age, weight, kidney function, and heart failure status, suggesting more personalized treatment selection.

Read the original research

Evolving trends of antidiabetic agents stratified by age, kidney function and body mass index: Insights from a nationwide claims database.

Diabetes, obesity & metabolism, 28(1), 701-710

View on PubMed ↗Publisher’s paper ↗

Citation

Aoyama, Kazuki; Okada, Akira; Kaneko, Hidehiro; Azegami, Tatsuhiko; Suzuki, Yuta; Meguro, Shu; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Node, Koichi; Yamauchi, Toshimasa; Nangaku, Masaomi; Takeda, Norihiko; Yasunaga, Hideo; Hayashi, Kaori. (2026). Evolving trends of antidiabetic agents stratified by age, kidney function and body mass index: Insights from a nationwide claims database.. Diabetes, obesity & metabolism, 28(1), 701-710. https://doi.org/10.1111/dom.70255