Inequities Seen in GLP-1 RA Use for Type 2 Diabetes in the U.S.

Use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) increased during the past five years but remains low among patients with type 2 diabetes, according to a study published online Dec. 17 in JAMA Health Forum.

Lauren A. Eberly, M.D., M.P.H., from the University of Pennsylvania in Philadelphia, and colleagues used data from OptumInsight Clinformatics Data Mart to evaluate GLP-1 RA uptake among 1,180,260 commercially insured patients with type 2 diabetes to identify associations between race, ethnicity, sex, and socioeconomic status and GLP-1 RA use.

The researchers found that 7.7 percent of patients with type 2 diabetes were treated with a GLP-1 RA between Oct. 1, 2015, and June 30, 2019. During the study period, the percentage of patients treated with a GLP-1 RA increased from 3.2 to 10.7 percent. Use also increased but remained low among patients with atherosclerotic cardiovascular disease (2.8 to 9.4 percent). Lower rates of GLP-1 RA use were found among Asian (adjusted odds ratio [aOR], 0.59), Black (aOR, 0.81), and Hispanic (aOR, 0.91) patients with type 2 diabetes. Higher GLP-1 RA use was seen among women (aOR, 1.22) and higher ZIP code-linked median household incomes (ORs, 1.13 and 1.07, respectively, for >$100,000 and $50,000 to $99,999 versus <$50,000).

“The findings of this cohort study suggest that racial, ethnic, and socioeconomic inequities are present in access to GLP-1 RA, a medication with established benefits for improved cardiovascular outcomes in patients with diabetes,” the authors write.

Several authors disclosed financial ties to medical and pharmaceutical companies.

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