Diabetes prescription patterns in Costa Rica and Panama among patients switching to a second-line medication. Evidence from the DISCOVER real-world diabetes registry.

Aims: : to describe the prescriptions patters of second line medications in patients with diabetes in Costa Rica and Panama. Methods: : DISCOVER is a registry of patients with type 2 diabetes that are switching from first- to second-line medications. We analyzed medication choice and reasons to switch by country. Results: : 219 patients were included, 127 in Costa Rica and 92 in Panama. The most frequently prescribed first-line medication was metformin, followed by sulphonylureas in Panama and a combination of metformin and dipeptidyl peptidase-4 inhibitors (iDPP4) in Costa Rica. DPP4 inhibitors plus metformin was the most commonly prescribed second line medication in both countries, followed by metformin combined with SGLT2 inhibitors in Costa Rica and iDPP4 in monotherapy in Panama. The main reason to switch was efficacy. When choosing the second-line medication, the main reasons were efficacy, weight loss, and hypoglycemia risk in both countries (tolerability was also common in Panama). Conclusions: : In these two Latin American countries the main reason to switch to second line medication was efficacy and the most prescribed agent was metformin plus iDPP4.