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Patterns and patient characteristics associated with use of SGLT2 inhibitors among adults with type 2 diabetes: A population-based cohort study

Published:August 09, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.08.002
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      Abstract

      Aims

      To describe patterns and patient-level factors associated with use of SGLT2-inhibitors (SGLT2i) among adults with diabetes treated in Alberta, Canada

      Methods

      Using linked administrative datasets from 2014-2019, we defined a retrospective cohort of adults with prevalent or incident type 2 diabetes with indications for SGLT2is and who did not have advanced kidney disease (GFR<30) or prior amputation. We described medication dispensation patterns of SGLT2i over time in the overall cohort and among the subgroup with cardiovascular disease (CVD). Multivariable logistic regression was used to determine patient characteristics associated with SGLT2i use.

      Results

      Of the 341,827 patients with diabetes (mean age 60.7 years; 45.6% female), 107,244 (31.3%) had CVD. The proportion of patients with a SGLT2i prescription increased in a linear fashion to a maximum of 10.8% (95% CI: 10.7%-10.9%) of the eligible cohort by the end of the observation period (March 2019). The proportion of filled prescriptions was similar for patients with CVD (10.4%, 95% CI: 10.1%-10.6%) and for those without CVD (10.9%, 95% CI: 10.8%-11.0%). Patient characteristics associated with lower odds of filling an SGLT2i prescription included female sex, older age, and lower income.

      Conclusions

      Use of SGLT2i is increasing among patients with diabetes but remains low even in those with CVD. Policy and practice changes to increase prescribing for those in whom SGLT2i may help to reduce morbidity and mortality related to cardiovascular and renal complications, particularly older adults.

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