Black patients with CKD and type 2 diabetes had significantly lower odds of initiating SGLT2i (OR 0.67; 95% CI 0.61-0.74) and GLP-1RA compared with White patients.
Cohort (n=53,029)
Yes
What sociodemographic and clinical factors are associated with the initiation of SGLT2 inhibitors or GLP-1 receptor agonists compared to sulfonylureas in Medicare-insured adults with CKD and type 2 diabetes?
Significant racial and age-based disparities exist in the real-world initiation of SGLT2 inhibitors and GLP-1 receptor agonists among Medicare patients with CKD and type 2 diabetes.
Odds Ratio: 0.67 (95% CI 0.61–0.74)
Rationale 95% CI, 0.61-0.74) and GLP-1RA (OR, 0.73; 95% CI, 0.68-0.79), compared with White patients. Hispanic and Asian patients had lower odds of initiation of GLP-1RA. Patients with cardiovascular disease or hyperlipidemia had higher odds to start SGLT2i or GLP-1RA. Limitations: CKD and type 2 diabetes diagnosis; CKD stage; and patient clinical status were identified with diagnosis or procedure codes. There is potential for residual confounding with the use of retrospective data. Conclusions: The results of this study identified disparities in the use of SGLT2i and GLP-1RA in patients with CKD. Black and older patients were significantly less likely to be initiated on SGLT2i or GLP-1RA than on second-generation sulfonylureas.
Zhao et al. (2022) conducted a cohort in Chronic kidney disease and type 2 diabetes (n=53,029). Black race vs. White race was evaluated on Initiation of SGLT2i compared with sulfonylureas (OR 0.67, 95% CI 0.61-0.74). Black patients with CKD and type 2 diabetes had significantly lower odds of initiating SGLT2i (OR 0.67; 95% CI 0.61-0.74) and GLP-1RA compared with White patients.