OBJECTIVES: There has been an increase in the utilization of Sodium-glucose cotransporter 2 (SGLT2) inhibitors and Glucagon-like peptide 1 (GLP-1) receptor agonists as they have been shown to reduce the risk of CKD progression, CV events, and HF hospitalizations. This study evaluated impact of these novel anti-diabetic medications on clinical outcomes and healthcare utilization compared to other oral anti-diabetic medications (oDM) in the real-world.

METHODS: This study utilized medical and pharmacy claims data linked to electronic health record data to identify patients newly initiated on SGLT2 inhibitors, GLP-1 agonists, and oDMs with a MPR >80%. Patients included were ≥18 years of age with type 2 diabetes (T2D) and a diagnosis of either atherosclerotic cardiovascular disease (ASCVD), HF or CKD prior to the index date, and had at least 2 HbA1c lab results, one before and after the medication index date. Outcomes measured were the difference in the proportion of patients with HbA1c <7.5% pre and post index date and the difference in the proportion of patients with ≥1 all-cause emergency department visits and hospitalizations within 1 year after initiation of the index medication.

RESULTS: 284 patients (n=58, SGLT2 inhibitors; n=86, GLP-1 agonists; n=140, oDM) met study criteria. The baseline HbA1c for SGLT2 inhibitors, GLP-1 agonists and oDM was 8.5, 8.6, and 7.3 respectively. The change in the proportion of patients achieving a HbA1C <7.5 pre and post index date was significant across all three groups (SGLT2 inhibitors, 22%, P<.001; GLP-1 agonists, 24%, P<.001; oDM, 11%, P<.02). Chi-square analysis revealed that there was no significant relationship between medication type and whether or not the patient was hospitalized (X²=1.8929, p=.39) or admitted to the ED (X²=.12173, p=.94).

CONCLUSIONS: Although not significant, patients initiated on GLP-1 agonists had a slight decrease in healthcare utilization. Future analysis will utilize propensity score matching to reduce differences between treatment group.