Real-World Treatment Patterns of Glucose-Lowering Agents Among Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease or At Risk for Cardiovascular Disease: An Observational, Cross-Sectional, Retrospective Study.

Sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are types of glucose-lowering medications for patients with type 2 diabetes (T2D). The American Diabetes Association, the American Association of Clinical Endocrinologists, and American College of Endocrinology have recommended these medications for patients who have been diagnosed with T2D and atherosclerotic cardiovascular disease or heart failure (ASCVD/HF). The purpose of this study was to find out how many patients in a US-based health insurance population with T2D and ASCVD/HF were treated with SGLT-2is, GLP-1 RAs, and other glucose-lowering medications from 2015 to 2019. Using insurance claims data, we identified 50- to 89-year-old patients with T2D and either ASCVD/HF or at least one risk factor for ASCVD/HF. We tracked the number of patients with T2D and either ASCVD/HF or ASCVD/HF risk factors who were using different glucose-lowering medications. Glucose-lowering medications were used in most patients (60­78%), but fewer than 11% of patients aged 50­64 years, and fewer than 5% of patients over 65 years of age were prescribed SGLT-2i and GLP-1 RA medications, despite clinical guidelines recommending their use for the above-mentioned indications. Increasing awareness among healthcare providers may be required to ensure patients with T2D and ASCVD/HF or ASCVD/HF risk factors are prescribed the guideline-recommended cardioprotective glucose-lowering agents.