Contemporary use of cardiovascular risk reduction strategies in type 2 diabetes. Insights from the diabetes collaborative registry
Authors' conclusion
In a large, contemporary cohort of patients with T2D, we found improvement in the use of SGLT2i and GLP-1RA but unexpectedly lower use in patients with ASCVD, heart failure, and CKD, highlighting a treatment-risk paradox.
Study context
- Population
- US outpatients with T2DM in a diabetes registry
- Participants
- 1,001,542 outpatients391 US sites
- Exposure
- Patients with ASCVD, HF or CKD vs patients without these comorbidities
- Outcome
- Prescription of SGLT2i or GLP-1RA over time and by high-risk comorbidity; diabetes cardiovascular composite score (DCCS, 0–100%)
Methodological detailslongitudinal outpatient registry, 391 US sites
- Longitudinal outpatient registry
- 391 US sites
Main finding
As reported in the abstract
| Group | Value | Mean diabetes cardiovascular composite score (DCCS) |
|---|---|---|
| ASCVD, HF, or CKD | 18.3% | 54±25% |
| Without comorbidities | 25.5% | 52±50% |
Value
ASCVD, HF, or CKD18.3%
Without comorbidities25.5%
Mean diabetes cardiovascular composite score (DCCS)
ASCVD, HF, or CKD54±25%
Without comorbidities52±50%
- SGLT2i or GLP-1RA prescription, 2013
- 7.3%
- SGLT2i or GLP-1RA prescription, 2019
- 28.8%
- Mean DCCS, overall
- 54±36%
- DCCS differences
- P < 0.001 for both
Observational data: associations, not effects.
Further findings
Factors associated with DCCS (hierarchical linear model)
- Male sex and CKD independently associated with higher DCCS; HF or ASCVD associated with lower DCCS
Original publication
Contemporary use of cardiovascular risk reduction strategies in type 2 diabetes. Insights from the diabetes collaborative registry. Am Heart J. Published 8 May 2023. doi:10.
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