Clinical Confidence Increases in Prescribing SGLT2i, GLP-1 for Type 2 Diabetes

While SGLT2 inhibitors and GLP-1 receptor agonists are known to provide cardiorenal benefits in type 2 diabetes patients, questions remain on the perceptions of clinicians on the use of these agents.

In a new study presented at the American Diabetes Association Virtual Meeting, investigators collected data on confidence in healthcare professionals in prescribing SGLT-2 and GLP-1s, as well as the medical specialities they consider responsible for prescribing these agents.

The team, led by Deena Zytnick, DrPH, American Heart Association, found that confidence in both SGLT-2 inhibitors and GLP-1 RAs has increased in T2D care specialists within the previous year.

Study

The study makeup used a national sample of healthcare professionals, collecting data on 1006 physicians, nurse practitioners, and physician assistants within the cardiology, endocrinology, nephrology, and primary care space.

In addition, inclusion criteria consisted of treating patients with T2D, with 20% of their time treating patients in an outpatient setting.

The online survey took place between November - December 2020.

The healthcare professionals were asked about current and past perceptions, as well as confidence in prescribing SGLT2 and GLP-1 for cardiorenal benefit.

Investigators analyzed the quantitative survey results using weighting for gender, region, and practice type.

Results

According to the data, participants were 56% male, with 53% of participants having >10 years experience and 32% who saw >100 patients a month with T2D.

Over 50% of all participants were in their position for more than 10 years, with 62% of practitioners working in a group practice.

Investigators noted 66% of all healthcare professionals in the study reported greater confidence in prescribing SGLT2 inhibitors compared to the previous year.

Of this number, cardiologists had the highest amount at 77% and nephrologists at 76%.

In addition, data show 55% of healthcare professionals reported greater confidence in prescribing GLP-1s compared to the previous year.

In this number, primary care professions had the highest proportion at 67%, with nurse practitioners following at 63%.

Following that, a larger proportion felt healthcare professionals now have more responsibility when prescribing SGLT2 and GLP-1 compared to the previous year.

Further, cardiologists at 84% noted their specialities now have more responsibility in prescribing agents for cardiorenal protection, compared to the previous year at 30%.

Then, nephrologists at 76% claimed more responsibility in prescribing agents for cardiorenal protection compared to 30% in the previous year.

Conclusion

Investigators noted the increase in confidence in prescription of SGLT2 inhibitors and GLP-1 for cardiorenal benefit within the previous year in all healthcare professional fields.

However, they noted that the lower confidence in GLP-1 compared to SGLT2 may be a result of the injectable mode of administration.

“These results also indicate a growing perception that prescribing these agents is not just the responsibility of a single specialty but is a shared responsibility across the T2D care team,” investigators wrote.

The study, “Changes in Perceptions and Confidence of Health Care Professionals across Medical Specialties Regarding Use of SGLT2 and GLP-1 for Cardiorenal Benefit in Type 2 Diabetes,” was published online by ADA.