ADA 2024: Gaps in the Initiation of Diabetes Drugs with Cardiovascular and Kidney Benefits by Medical Specialists
Despite guidelines recommending GLP-1 receptor agonists (GLP-1RA) and SGLT2 inhibitors (SGLT2i) for patients with diabetes along with cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD), utilisation specifically among older adults remains suboptimal.
This retrospective study used a 100% sample of 2019 Medicare fee-for-service claims retrieved from American Board of Internal Medicine records. They identified the percentages of medicinally treated patients ≥66 years suffering from diabetes alongside CVD, HF, or CKD treated by endocrinologist, nephrologist, or cardiologist and eventually filled GLP-1RA or SGLT2i prescribed by any of these specialists. The logistic regression has been used to quantify the relationship between GLP-1RA/SGLT2i prescription and patient and physician features.
They found 402,922/330,003/638,408 pharmacologically treated patients seen by 5,338/8,059/10,761 endocrinologists/nephrologists/cardiologists, correspondingly. Few nephrologists (6.3%) and cardiologists (4.0%) gave antidiabetic medications to their patients, compared to the majority of endocrinologists (73.7%). Amongst the patients they recommended to, only 12.2% of nephrologists, 13.9% of cardiologists, and 26.6% of endocrinologists filled a GLP-1RA or SGLT2i prescription from that specialist. Throughout specialities, older patients used GLP-1RA or SGLT2i less (10-25 percentage points less for ≥85 versus 66–69-year-olds). Variations were also found based on race, dual Medicare/Medicaid eligibility, and physician age.
This concludes that nephrologists and cardiologists who care for people with diabetes infrequently prescribe GLP-1RA and SGTL2i to patients who might gain improvement from them, and they might benefit from further training and assistance to do so, particularly in older adults.
1407-P: American Diabetes Association (ADA) 84th Scientific Sessions, 2024, 21- 24 June 2024, Orlando, Florida.
