Only 1 in 4 High-Risk Diabetic Heart Patients Gets Proven Cardioprotective Drugs
A registry of 8,000+ patients reveals glaring underprescription of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes with established cardiovascular disease.
Summary
A retrospective analysis of 8,096 adults with type 2 diabetes and established ASCVD found that only 22% were prescribed SGLT2 inhibitors and 25.3% GLP-1 receptor agonists, despite strong guideline recommendations. Significant disparities existed by sex, race, and insurance status. Men were more likely to receive SGLT2i, while women were more likely to receive GLP-1RAs. Private insurance strongly predicted receipt of both drug classes. The study highlights a major implementation gap in secondary cardiovascular prevention at a large tertiary center.
Detailed Summary
This study does not address longevity mechanisms, aging biology, healthspan interventions, or functional capacity. It is a healthcare utilization and prescribing-disparity analysis examining why certain patient subgroups are less likely to receive two medication classes at a single institution.
Key Findings
- Only 22% of T2D+ASCVD patients received SGLT2i prescriptions
- Only 25.3% received GLP-1RA prescriptions despite guideline recommendations
Methodology
Retrospective cohort study of 8,096 adults from Houston Methodist EMR registry (2016–2023). ICD-10 and lab-based algorithms identified T2D and ASCVD. Multivariable logistic regression assessed prescription predictors.
Study Limitations
Single-center retrospective design at a large tertiary referral center limits generalizability; reliance on ICD-10 codes and EMR data may miss prescriptions filled outside the system; study period (2016–2023) may not reflect most recent prescribing shifts.
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