Factors associated with A1C reduction with GLP-1 agonist or SGLT-2 inhibitor use.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 8500875 Publication Model: Print Cited Medium: Internet ISSN: 1460-2229 (Electronic) Linking ISSN: 02632136 NLM ISO Abbreviation: Fam Pract Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Oxford University Press, [c1983-
    • Subject Terms:
      Diabetes Mellitus, Type 2*/drug therapy ; Sodium-Glucose Transporter 2 Inhibitors*/therapeutic use; Female ; Glucagon-Like Peptide 1 ; Glucagon-Like Peptide-1 Receptor ; Glycated Hemoglobin ; Humans ; Hypoglycemic Agents ; Middle Aged ; Retrospective Studies
    • Abstract:
      Background: While use of glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors reduces the risk of atherosclerotic cardiovascular disease outcomes and lowers glycosylated haemoglobin (A1C), evidence on patient characteristics associated with clinically relevant A1C reduction is lacking.
      Objective: The objective of this retrospective cohort study was to identify patient characteristics associated with A1C reduction with initial GLP-1 or SGLT-2 use.
      Methods: Patients with type 2 diabetes and a baseline A1C ≥7% who were dispensed a GLP-1 or SGLT-2 between 01/01/10 and 12/31/17 were included. Patients were categorized as having a ≥1% or <1% A1C reduction during the 90-365 days after GLP-1/SGLT-2 initiation. Patient characteristics were collected during the 180 days prior to initiation. Multivariable logistic and linear regression modelling was performed to identify characteristics associated with a ≥1% A1C reduction and absolute change in A1C, respectively.
      Results: Five hundred and seventy-two patients were included with 261 (46%) and 311 (54%) having and not having an ≥1% A1C reduction. Patients were primarily middle-aged, female, white, non-Hispanic and had a high burden of chronic disease. Characteristics associated with a ≥1% A1C reduction included: GLP-1/SGLT-2 persistence, congestive heart failure comorbidity, phentermine dispensing, care management team (CMT) enrollee and higher baseline A1C. Characteristics associated with absolute A1C reduction included: age, baseline A1C, CMT enrollee, GLP-1/SGLT-2 persistence and a phentermine dispensing.
      Conclusions: The results of this study provide practitioners with guidance on the patients who are most likely to have a clinically relevant A1C reduction with GLP-1 or SGLT-2 use.
      (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].)
    • Contributed Indexing:
      Keywords: Diabetes mellitus; glucagon-like peptide-1 receptor; glycated haemoglobin A; patient care management; regression analysis; sodium-glucose transporter-2 inhibitors
    • Accession Number:
      0 (Glucagon-Like Peptide-1 Receptor)
      0 (Glycated Hemoglobin A)
      0 (Hypoglycemic Agents)
      0 (Sodium-Glucose Transporter 2 Inhibitors)
      89750-14-1 (Glucagon-Like Peptide 1)
    • Publication Date:
      Date Created: 20210323 Date Completed: 20211125 Latest Revision: 20221207
    • Publication Date:
      20240628
    • Accession Number:
      10.1093/fampra/cmab021
    • Accession Number:
      33755123