Prescription Patterns of Novel Antihyperglycemic Medications.

Abstract

Glucagon-like peptide-1 agonists (GLP-1a) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are recommended in carefully selected patients with type 2 diabetes. This study will assess prescription of these medications and investigate predictors of prescription. This retrospective cross-sectional study included 31,354 patients. Data including sociodemographic descriptors, clinical histories, medications, and health insurance providers were extracted from a health system's administrative databases. Variables to be associated with prescription of a GLP-1a or SGLT-2i were assessed using a multivariable logistic regression model. Mean age was 62.58 years and 40.8% identified as African American. Only 3.4% were prescribed a GLP-1a and 2.1% received a SGLT-2i. Logistic regression demonstrated lower odds of receiving either medication in the highest age-group (70 to 79 years) (GLP-1a: odds ratio [OR] 0.44, <i>P</i> < <i>.01</i>, SGLT-2i: OR 0.39, <i>P</i> < <i>.01</i>) and in African Americans (GLP-1a: OR 0.64, <i>P</i> < <i>.01</i>, SGLT-2i: OR 0.28, <i>P</i> < <i>.01</i>). Atherosclerotic cardiovascular disease was not associated with GLP-1a prescription (<i>P</i> = <i>.54</i>) and conferred lower odds of being prescribed SGLT-2i (OR 0.68, <i>P</i> < <i>.01</i>). History of chronic kidney disease conferred lower odds of receiving GLP-1a and was not associated with the odds of receiving SGLT-2i. Prescription of GLP-1a and SGLT-2i medications was low as compared with existing literature. Advanced age and African American race were negatively associated with prescription of these medications. Contrary to guideline recommendations; atherosclerotic cardiovascular disease and chronic kidney disease were not positively associated with prescription.