What question did this study set out to answer?

The study aims to explore how socioeconomic factors influence the use of GLP-1 receptor agonists and SGLT2 inhibitors in eligible adults with type 2 diabetes.

June 7, 2026

1969-P: Socioeconomic Differences in Use of GLP-1 Receptor Agonists and SGLT2 Inhibitors among Eligible U.S. Adults with Type 2 Diabetes

Key Points

The study aims to explore how socioeconomic factors influence the use of GLP-1 receptor agonists and SGLT2 inhibitors in eligible adults with type 2 diabetes.
Pooled data from the 2018-2020 and 2021-2023 Medical Expenditure Panel Survey.
Identified adults with type 2 diabetes meeting eligibility criteria for treatment based on American Diabetes Association guidelines.
Conducted weighted analyses and logistic regression to assess use by socioeconomic factors.
Approximately 75% of U.S. adults with type 2 diabetes met at least one eligibility criterion during both periods.
Use of GLP-1 RA or SGLT2i increased from 12.3% to 26.5% among eligible adults.
Utilization was notably lower among racial and ethnic minorities as well as uninsured or publicly insured adults, with higher rates observed in those with incomes ≥400% of the federal poverty level.

Abstract

Introduction and Objective: GLP-1 receptor agonist (GLP-1 RA) and sodium-glucose cotransporter 2 inhibitor (SGLT2i) are guideline-recommended therapies that reduce cardiovascular and renal risk in adults with type 2 diabetes (T2D). Uptake varies by socioeconomic factors. We examined socioeconomic differences in use among eligible U.S. adults with T2D. Methods: We pooled 2018-2020 and 2021-2023 Medical Expenditure Panel Survey data to identify adults with T2D and determine eligibility using American Diabetes Association criteria. Eligibility included having atherosclerotic cardiovascular disease (ASCVD) or high ASCVD risk for GLP-1 RA or SGLT2i use, or having heart failure or chronic kidney disease for SGLT2i use. Weighted analyses estimated overall and subgroup use by race/ethnicity, income, insurance status, and region. Logistic regression assessed associations between use with socioeconomic, and clinical features. Results: About three-quarters of U.S. adults with T2D met at least one eligibility criterion in both periods. Among eligible adults, use of GLP-1 RA or SGLT2i increased from 12.3% to 26.5%. Use was lower among racial and ethnic minority groups and uninsured or publicly insured adults, and highest among adults with incomes ≥400% of the federal poverty level. Conclusion: Despite broad eligibility, substantial socioeconomic disparities persist in use of GLP-1 RAs and SGLT2 inhibitors, stressing the need to improve equitable access. Disclosure Y. Wang: None. K. Bullard: None. R. Li: None. O. Idubor: None. P. Zhang: None.

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