Obesity and Type 2 Diabetes: Analyzing Treatment Patterns and Socio-Economic Factors in Real-World Evidence

OBJECTIVES: The current attention towards the study of obesity and type 2 diabetes (T2D) highlights an evolving landscape in treatment approaches. This study aims to examine the medication prescription patterns and explore the socio-economic aspects of patients with T2D and obesity.

METHODS: Using the OPTUM claims data from 2007 to 2020, we identified adult patients with T2D who had no diabetic medication prescriptions for at least one year and maintained continuous enrollment for one year before and after their first T2D prescription. Pregnancy-related T2D cases were excluded. Logit model analyzed the prescription patterns and impact of socio-economic factors on T2D and obesity. Covariates included socio-economic (age, race, income, education, insurance type) and baseline clinical factors (diagnostic and prescription drugs used for hypertension, blood pressure, cardiovascular diseases).

RESULTS: This study examined 735,511 patients with T2D, who were on average 59 years old and 51% male. In the baseline period, the year preceding the initial T2D prescription, 23% had an obesity diagnosis. After controlling for baseline covariates, obese patients had a 36% probability of being first prescribed glucagon-like peptide-1(GLP-1) agonists, followed by 28% for sodium-glucose cotransporter-2 inhibitors and 25% for metformin. In this cohort, Hispanics had the highest obesity rate at 25%, HMO enrollees at 26%, and those with less than 12^th-grade education at 27%.

CONCLUSIONS: The study highlights a preference for GLP-1 agonists in treating T2D with obesity, aligning with their weight loss benefits, alongside observed socio-economic disparities among patients with T2D and obesity.