Abstract: FR-PO333
Use of SGLT2 Inhibitors and Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists in Australian Primary Care Patients with Type 2 Diabetes Mellitus (T2DM) Stratified by CKD Status
Session Information
- Diabetic Kidney Disease: Clinical Modeling, Diagnosis, Education, and More
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Wallace, Hannah, The George Institute for Global Health, Sydney, New South Wales, Australia
- Wick, James, University of Calgary, Calgary, Alberta, Canada
- Ketema, Daniel Bekele, The George Institute for Global Health, Sydney, New South Wales, Australia
- Neuen, Brendon Lange, The George Institute for Global Health, Sydney, New South Wales, Australia
- Jardine, Meg, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
- Lin, Jialing, University of New South Wales, Sydney, New South Wales, Australia
- Nelson, Craig L., The University of Melbourne, Melbourne, Victoria, Australia
- Pearson, Sallie, University of New South Wales, Sydney, New South Wales, Australia
- Peiris, David, The George Institute for Global Health, Sydney, New South Wales, Australia
- Woodward, Mark, The George Institute for Global Health, Sydney, New South Wales, Australia
- Ronksley, Paul E., University of Calgary, Calgary, Alberta, Canada
- Gallagher, Martin P., The George Institute for Global Health, Sydney, New South Wales, Australia
- Kotwal, Sradha S., The George Institute for Global Health, Sydney, New South Wales, Australia
- Jun, Min, The George Institute for Global Health, Sydney, New South Wales, Australia
Group or Team Name
- CKD-CARE.
Background
SGLT2i and GLP1-RA reduce the risk of kidney failure and cardiovascular events in patients with T2DM and CKD. We aim to understand their use in Australian primary care patients with T2DM by CKD status.
Methods
We identified adults (>18 years) with T2DM who attended 1 of 392 general practices participating in a national quality improvement program (MedicineInsight) and had ≥1 eGFR measure between 2011-2019. CKD was defined according to KHA-CARI/KDIGO guidelines. Outcomes assessed were ≥1 prescription for SGLT2i (if eGFR >20ml/min/1.73m2) or GLP1-RA (if eGFR >15ml/min/1.73m2) during 2020-2021, by CKD status. Two secondary analyses were conducted; SGLT2i use in patients with CKD with UACR >22.6mg/mmol, and GLP1-RA use in those meeting CKD outcome trial enrolment criteria (NCT03819153; see figure for eGFR/UACR definitions).
Results
114,499 adults with T2DM were included (113,563 and 113,940 with eGFR >20 and >15mL/min/1.73m2, respectively), with a median age of 68, of whom 45% were female, and 32% had CKD. SGLT2i were prescribed 13% in patients without CKD, 14% with CKD and 17% with CKD and UACR >22.6mg/mmol (p values vs. no CKD: <0.05). GLP1-RA were prescribed in 8% of patients without CKD, 10% with CKD and 11% meeting CKD outcome trial inclusion criteria (p values vs. no CKD: <0.05).
Conclusion
In this large, contemporary primary care cohort of patients with T2DM, SGLT2i and GLP1-RA prescription rates were higher in CKD than those without, but relatively low across both groups. Implementation strategies to improve medication uptake, with a focus on those who are likely to derive greatest benefit are needed.
Funding
- Commercial Support – The Renal Division of The George Institute for Global Health has received sponsorship funding provided by Boehringer Ingelheim and Eli Lilly Alliance and is supported by the University of New South Wales Scientia Program. The design, analysis, interpretation or writing of this work was performed independent of all funding bodies.