Key result
Chronic ischemic heart disease is linked to ~55% higher odds of SGLT2i or GLP-1RA prescription.
Why the study?
Real-world prescribing patterns of SGLT2 inhibitors and GLP-1 receptor agonists and factors associated with their receipt remained unclear in newly diagnosed T2DM patients, especially those with high cardiovascular risks or chronic kidney disease.
Are demographic, clinical, and system-level factors associated with the prescription of SGLT2 inhibitors and GLP-1RAs in newly diagnosed Type 2 diabetes patients?
Cross-Sectional (n=5,783)
Yes
Are demographic, clinical, and system-level factors associated with the prescription of SGLT2 inhibitors and GLP-1RAs in newly diagnosed Type 2 diabetes patients?
Odds Ratio: 1.55 (95% CI 1.11–2.18)
Absolute Event Rate: 20% vs 18.7%
This study underscores significant clinical inertia, demonstrating that evidence-based SGLT2 inhibitor and GLP-1RA prescriptions remain low in primary care, even among newly diagnosed T2DM patients with clear cardiorenal indications.
Low prescribing rates persist in high-risk T2DM; leaves open targeted interventions to address inertia in primary care.
Aims The aim of this study is to evaluate the real‐world prescribing patterns of SGLT2 inhibitors and GLP‐1 receptor agonists (GLP‐1RA) in patients with newly diagnosed Type 2 diabetes (T2DM), particularly among those with high cardiovascular risks or chronic kidney disease, and to identify demographic, clinical, and system‐level factors associated with receiving these medications. Materials and Methods This cross‐sectional study analyzed electronic medical records (EMRs) of patients with newly diagnosed T2DM from 60 primary care clinics in West Michigan between April 2021 and January 2023. We assessed the documented prescription rates of SGLT2 inhibitors and GLP‐1RAs within 3 months of diagnosis based on EMRs, particularly in high‐risk subgroups. Results Overall, 19.9% of n = 5783 patients with newly diagnosed T2DM had either an SGLT2 inhibitor or GLP‐1RA prescribed. Prescription rates for these agents were 20.0% for patients with chronic ischemic heart disease and 19.3% for those with impaired kidney function. In adjusted analyses, higher BMI (aOR 2.92 for BMI > 40 kg/m 2 , 95% CI 1.58–5.42, ref BMI < 24 kg/m 2 ), hyperlipidemia (aOR 1.89, 95% CI 1.28–2.79), chronic ischemic heart disease (aOR 1.55, 95% CI 1.11–2.18), and higher HbA1c (aOR 1.32 per 1% increase, 95% CI 1.22–1.42) were associated with higher odds of receiving prescription of these medications. Conclusions Despite guideline recommendations, SGLT2 inhibitors and GLP‐1RAs are prescribed to only a minority of patients with newly diagnosed T2DM, even among those with clear indications. Efforts to improve guideline‐adherent care in primary care settings are needed.
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Müller et al. (2025) conducted a cross-sectional in Newly diagnosed Type 2 diabetes (n=5,783). Chronic ischemic heart disease vs. Patients without chronic ischemic heart disease was evaluated on Prescription of SGLT2 inhibitor or GLP-1 receptor agonist within 3 months of diagnosis (aOR 1.55, 95% CI 1.11-2.18). Chronic ischemic heart disease was associated with higher odds of receiving a prescription for SGLT2 inhibitors or GLP-1RAs (aOR 1.55), though overall prescription rates remained low at 19.9%.
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