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Abstract: SA-PO487

Prescribing of Sodium Glucose Co-Transporter 2 Inhibitors Among Hispanic/Latino Individuals Within Duke University Health System

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Sinclair, Matthew R., Duke University School of Medicine, Durham, North Carolina, United States
  • Feng, Yixuan, Duke University School of Medicine, Durham, North Carolina, United States
  • Diamantidis, Clarissa Jonas, Duke University School of Medicine, Durham, North Carolina, United States
  • Goldstein, Benjamin A., Duke University Department of Biostatistics and Bioinformatics, Durham, North Carolina, United States
Background

Type 2 diabetes (T2D) is a risk factor for cardiovascular disease, chronic kidney disease, and death. Lifetime prevalence of T2D in Hispanic/Latino individuals is over 50%. One medication class, the sodium glucose co-transporter 2 inhibitors (SGLT2is), improve cardiovascular and kidney outcomes among patients with T2D. Unfortunately, recent national evidence shows that racial and ethnic minority individuals with T2D, including Hispanics/Latinos, are less likely to receive SGLT2is compared to non-Hispanic White individuals. Prescribing patterns of SGLT2is within Duke University Health System (DUHS) are currently unknown. We examined prescribing rates and likelihood of SGLT2i prescribing among Hispanic/Latino individuals with T2D within DUHS compared to other races and ethnicities.

Methods

We extracted data from the DUHS electronic health record system to identify adults with T2D eligible to receive an SGTL2i. Starting in January of 2017, we defined eligibility as having a diagnosis code for T2D and an outpatient encounter with a hemoglobin A1C >6.5%. Patients were followed until either receiving an SGLT2i, losing eligibility (i.e., eGFR < 30 or A1C < 6.5%), death, or follow-up through December 31, 2022. We assessed time to SGLT2i prescribing based on race/ethnicity, accounting for competing risks in a subdistribution hazard model.

Results

Among adults with T2D (n = 6,653), Hispanic/Latino individuals had a lower cumulative incidence of SGLT2i prescriptions (10.1%) compared to both non-Hispanic Black (16.3%) and non-Hispanic White (17.5%) individuals (p=0.12). After adjusting for age, sex, type of health insurance, area deprivation index, and comorbidities, there was suggestion of a decreased likelihood of prescribing among Hispanic/Latino individuals when compared to both non-Hispanic Black (adjusted hazard ratio (aHR) 0.77 (95%CI: 0.53 – 1.11)) and non-Hispanic White (aHR 0.77 (95%CI:0.53-1.12)) individuals.

Conclusion

SGLT2is are prescribed at low rates among patients with T2D within DUHS, consistent with national trends. Likelihood of prescribing was lowest among Hispanic/Latino individuals, even after adjustment for key demographics and clinical comorbidities, when compared to their non-Hispanic Black and White counterparts.