OBJECTIVE  To systematically analyze the utilization and application trends of hypoglycemic drugs in National and Fujian medical and health institutions, and to provide reference for rationally adjusting the structure and formulating relevant policies.

METHODS  Based on national drug usage monitoring data from 47 096 medical and health institutions ,a system analysis of the utilization of hypoglycemic drugs was used through indicators such as medication frequency, limited daily cost, and ranking ratio.

RESULTS  In 2021, the largest proportion of non-insulin hypoglycemic drugs DDDs in the country is metformin (29.90%), followed by sulfonylureas(25.02%) and alpha-glucosidase inhibitors(17.16%). Sulfonylureas(36.10%) account for the largest proportion of consumption in primary medical and health institutions. The largest proportion of drugs used in Fujian is sulfonylureas(28.70%) too. The highest proportion of DDDs among insulin-based hypoglycemic drugs in the country is premixed insulin(48.10%), followed by long-acting(26.62%), short-acting(13.71%), rapid-acting(9.78%) and intermediate-acting insulin (1.79%). However, long-acting insulin accounts for the highest proportion in tertiary hospitals(37.41%). From 2021 to 2023, metformin accounts for the largest proportion in tertiary hospitals in Fujian. The dosage of DPP-4i increased steadily, SGLT-2i increased significantly, GLP-1RA increased less and sulfonylureas declined year by year. The proportion of long-acting insulin usage remained stable, rapid-acting insulin increased, while premixed insulin decreased year by year.

CONCLUSION  The use of hypoglycemic drugs in medical institutions across the country and Fujian is basically consistent with the recommendations of relevant guidelines.The role of the national policy of organizing centralized and large-scale drug procurement to benefit the people has been highlighted, and the average daily cost of hypoglycemic drugs has dropped significantly. Evidence-based evidence is increasingly becoming an important basis for correct clinical selection of drugs, but must also be paid to the optimization of the medication structure of hypoglycemic drugs in primary medical and health institutions.