ASSOCIATIONS OF SOCIODEMOGRAPHIC AND CLINICAL FACTORS WITH GLP-1 RECEPTOR AGONIST UTILIZATION AMONG U.S. ADULTS WITH DIABETES, A CROSS-SECTIONAL ANALYSIS OF 2024 NHIS DATA
Author(s)
Julianne A. Mercer, PharmD, Benjamin A. Encino, PharmD, Justina S. Lipscomb, PharmD, Grace C. Lee, PharmD, PhD;
University of Texas at Austin, College of Pharmacy, Division of Pharmacotherapy and Translational Sciences, San Antonio, TX, USA
University of Texas at Austin, College of Pharmacy, Division of Pharmacotherapy and Translational Sciences, San Antonio, TX, USA
OBJECTIVES: This study assessed associations of sociodemographic and clinical factors with current glucagon-like peptide-1 receptor agonist (GLP-1RA) use among U.S. adults with diabetes.
METHODS: We conducted a cross-sectional analysis of adults aged ≥18 years with self-reported diabetes using 2024 National Health Interview Survey data. Multivariable logistic regression examined associations between GLP-1RA use (self-reported) and sex, race/ethnicity, education, and insulin use, adjusting for obesity (BMI 30 kg/m² or greater), age (18-64 vs 65 years or older), income, comorbidity, and insurance. Effect modification by age was assessed via interaction terms with sex, race/ethnicity, education, and insulin use. Analyses accounted for complex survey design.
RESULTS: Among U.S. adults with diabetes, 26.6% (6.5 million; 95% CI 24.7-28.6) reported GLP-1RA use; mean age 59.9 years, BMI 31.9 kg/m². Adjusted analyses showed higher odds among younger adults (18-64 vs ≥65 years; aOR 1.77, 95% CI 1.42-2.2), as did those with obesity (aOR 1.67, 95% CI 1.36-2.09). Higher family income-to-poverty ratio was associated with greater GLP-1RA use (aOR 1.05; 95% CI, 1.01-1.09). Lower education (aOR 0.74, 95% CI 0.60-0.92) and Asian race (aOR 0.57, 95% CI 0.33-0.99) associated with lower odds; insulin use (aOR 1.29, 95% CI 1.05-1.59) and Hispanic ethnicity (aOR 1.53, 95% CI 1.11-2.12) associated with higher odds versus non-Hispanic Whites. Sex, comorbidities, and insurance were not significant. Age-stratified models showed lower odds persisted among younger Asian adults (aOR 0.43, 95% CI .21-.87) but not Asian adults 65 years or older, while older Hispanic adults had more than double the odds (aOR 2.37, 95% CI 1.59-3.53) versus non-Hispanic Whites.
CONCLUSIONS: Educational and income disparities in GLP-1RA use persisted despite adjustment for insurance coverage, suggesting barriers beyond insurance access. Age-dependent racial/ethnic patterns revealed lower use among younger Asian adults but substantially higher use among older Hispanic adults, highlighting emerging inequities and heterogeneity in GLP-1RA uptake.
METHODS: We conducted a cross-sectional analysis of adults aged ≥18 years with self-reported diabetes using 2024 National Health Interview Survey data. Multivariable logistic regression examined associations between GLP-1RA use (self-reported) and sex, race/ethnicity, education, and insulin use, adjusting for obesity (BMI 30 kg/m² or greater), age (18-64 vs 65 years or older), income, comorbidity, and insurance. Effect modification by age was assessed via interaction terms with sex, race/ethnicity, education, and insulin use. Analyses accounted for complex survey design.
RESULTS: Among U.S. adults with diabetes, 26.6% (6.5 million; 95% CI 24.7-28.6) reported GLP-1RA use; mean age 59.9 years, BMI 31.9 kg/m². Adjusted analyses showed higher odds among younger adults (18-64 vs ≥65 years; aOR 1.77, 95% CI 1.42-2.2), as did those with obesity (aOR 1.67, 95% CI 1.36-2.09). Higher family income-to-poverty ratio was associated with greater GLP-1RA use (aOR 1.05; 95% CI, 1.01-1.09). Lower education (aOR 0.74, 95% CI 0.60-0.92) and Asian race (aOR 0.57, 95% CI 0.33-0.99) associated with lower odds; insulin use (aOR 1.29, 95% CI 1.05-1.59) and Hispanic ethnicity (aOR 1.53, 95% CI 1.11-2.12) associated with higher odds versus non-Hispanic Whites. Sex, comorbidities, and insurance were not significant. Age-stratified models showed lower odds persisted among younger Asian adults (aOR 0.43, 95% CI .21-.87) but not Asian adults 65 years or older, while older Hispanic adults had more than double the odds (aOR 2.37, 95% CI 1.59-3.53) versus non-Hispanic Whites.
CONCLUSIONS: Educational and income disparities in GLP-1RA use persisted despite adjustment for insurance coverage, suggesting barriers beyond insurance access. Age-dependent racial/ethnic patterns revealed lower use among younger Asian adults but substantially higher use among older Hispanic adults, highlighting emerging inequities and heterogeneity in GLP-1RA uptake.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH93
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)