Cardiometabolic & kidneyRandomised controlled trial
Safety of a remote disease management program to improve sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists prescribing in type 2 diabetes with elevated cardiovascular or kidney risk
- pragmatic, randomized clinical trial
- large integrated health care system in Massachusetts
Authors' conclusion
A remote, pharmacist- and navigator-led program safely initiated SGLT2i and GLP1 RA in a high-risk T2D population, with AE rates comparable to clinical trials and high persistence. These findings support the feasibility of remote prescribing with appropriate clinical oversight and structured AE management.
Study context
- Population
- Patients with T2D and elevated cardiovascular or kidney riskenrolled, 106 (53%) initiated SGLT2i (n = 68) or GLP1 RA (n = 40) · SGLT2i initiators 68 · GLP1 RA initiators 40
- Participants
- 200 patients
- Comparison
- sequential approach vs bundled approach
Further findings
Medication initiation
- Initiated SGLT2i or GLP1 RA, of 200 enrolled
- 106 (53%)
Safety
Adverse events (AEs) among SGLT2i users · first 6 months after enrollment
- Reported an AE
- 29.4%
- Genital mycotic infections
- 10.3%
- Symptoms of volume depletion
- 11.8%
- Discontinued due to AEs
- 10.3%
AEs among GLP1 RA users · first 6 months after enrollment
- Experienced AEs, predominantly gastrointestinal
- 55.0%
- Discontinued due to AEs
- 10.0%
Severe hypoglycemia, emergency department visits, hospitalizations
- No severe hypoglycemia, emergency department visits, or hospitalizations occurred
Original publication
Safety of a remote disease management program to improve sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists prescribing in type 2 diabetes with elevated cardiovascular or kidney risk. Am Heart J. Published 27 January 2026. doi:10.1016/j.ahj.2026.107359
Summarised from the published abstract; every number is checked against it