2322-P: Pharmacoepidemiology of Patients with Type 2 Diabetes and End-Stage Kidney Disease on Dialysis: A U.S. Nationwide Analysis from 2013–2017

Introduction and Objective: Type 2 diabetes (T2D) is a common cause of end-stage kidney disease (ESKD). Diabetes management in this population is challenging. This study aimed to describe national trends in the use of antidiabetic medications among patients with T2D and ESKD. Methods: We conducted a retrospective analysis of the USRDS database (2013-2017), including adults (≥18 years) with T2D on dialysis for ≥3 months. Descriptive statistics were used, and hypoglycemia rates (1,000 person-years) were calculated across treatment subgroups, with p 0.05 considered significant. Results: Among 244,279 patients included (mean age 64.8 ± 11.9 years; 47.9% female), prescriptions for human insulin declined (10.4% to 6.7%), while for insulin analogues increased (18.3% to 23.3%) from 2013 to 2017. Use of DPP-4 inhibitors (DPP-4i) and GLP-1 (GLP-1a) agonists increased from 7.7% to 11.7% and from 0.5% to 1.5%, respectively. Sulfonylurea use decreased from 24.0% to 19.7% (Figure 1.). Rates of severe hypoglycemia among users of sulfonylureas and glinides were 75.39 and 51.82 per 1,000 person-years, respectively. Conclusion: We found improvements in prescribing patterns, including decreased utilization of human insulin and sulfonylureas. However, use of antidiabetic agents with lower hypoglycemic risk (DPP-4i and GLP-1a) was low, while hypoglycemia remains common among patients with T2D and ESKD. Disclosure J. Martins de Oliveira: None. D. Soliman: None. A.J. Macias: None. R. McCoy: None. S. Inselman: None. J. Munoz Mendoza: None. G. Umpierrez: Research Support; Current; Abbott, Dexcom, Inc., Bayer AG. Advisory Panel; Ended; Sanofi-Aventis U.S., Dexcom, Inc. Other - Education grant; Current; Lilly Diabetes, Abbott Diabetes. Advisory Panel; Current; Glycare, Glucotrack. Research Support; Current; Corcept Therapeutics. R.J. Galindo: Consultant; Ended; Abbott, Boehringer Ingelheim International GmbH, Dexcom, Inc., Eli Lilly and Company, Gan Current; Roche Pharmaceuticals, Boehringer Ingelheim International GmbH, Novo Nordisk.