Abstract: FR-PO331
Exploring Patient and Physician Perspectives on the Use of SGLT2 Inhibitors for Adjunct-to-Insulin Treatment in Patients Living with Type 1 Diabetes
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
- Sridhar, Vikas, University Health Network, Toronto, Ontario, Canada
- Leblanc, Pamela L., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Parezanovic, Chloe, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Campbell, David, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Perkins, Bruce A., Sinai Health, Toronto, Ontario, Canada
- Senior, Peter A., University of Alberta, Edmonton, Alberta, Canada
- Sigal, Ronald J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Layton, Anita T., University of Waterloo, Waterloo, Ontario, Canada
- Barbour, Sean, The University of British Columbia, Vancouver, British Columbia, Canada
- Levin, Adeera, The University of British Columbia, Vancouver, British Columbia, Canada
- Lam, Tony K.T., University Health Network, Toronto, Ontario, Canada
- Mucsi, Istvan, University Health Network, Toronto, Ontario, Canada
- Rabasa-Lhoret, Remi, Universite de Montreal, Montreal, Quebec, Canada
- Lovblom, Leif Erik, University Health Network, Toronto, Ontario, Canada
- Stanimirovic, Aleksandra, University Health Network, Toronto, Ontario, Canada
- Rac, Valeria E., University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Cherney, David, University Health Network, Toronto, Ontario, Canada
Background
Sodium-glucose co-transporter inhibitors (SGLTi) have proven cardiorenal benefits in type 2 diabetes and are promising as adjunct-to-insulin therapy in patients with type 1 diabetes (T1D). However, their regulatory approvals and clinical use in T1D have been limited owing to the augmented risk of diabetic ketoacidosis (DKA). Patient and physician input is critical in understanding how and when the risk-benefit ratio with these therapies is perceived to be favorable for users. This study aimed to explore how risks and benefits of SGLTi are considered by patients with T1D and physicians who treat the condition, particularly in the context of diabetic kidney disease (DKD).
Methods
We used a qualitative descriptive study design, in which we conducted semi-structured interviews with T1D patients (with and without DKD) and physicians who treat this population. Participants were sampled from multiple Canadian sites via online recruitment. Transcripts were analysed inductively using conventional qualitative content analysis to identify themes.
Results
We interviewed 22 patients with long-standing T1D including those with DKD, whose duration of living with diabetes ranged from 8-62 years. We also interviewed 7 physicians, including endocrinologists and nephrologists with a range of 4-20+ years in practice. Our analysis revealed four major themes: i) Strong motivation towards innovative treatments that can improve glycemia and yield cardiorenal benefits; ii) The need for a personalized approach when considering SGLTi initiation – as it was considered to be “not for everyone”; iii) Mitigating risk of DKA through proactive patient and prescriber-oriented strategies; and iv) Concern over absence of empirical evidence and regulatory approvals for this indication.
Conclusion
While there is great interest and motivation toward the use of SGLTi among patients with T1D (both with and without DKD), and the physicians who treat them, there is also clear understanding by all, of the need for personalization of therapy and support for robust evidence to inform care.
Funding
- Government Support – Non-U.S.