Why carry out this study?

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) with proven cardiorenal benefits are recommended in individuals with type 2 diabetes and obesity.

In type 2 diabetes, key barriers to optimal glycaemic control include lack of persistence with treatment, reduced medication adherence and therapeutic inertia. While the effect of persistence is known for some conventional glucose-lowering drugs, little is known about these measures for GLP-1RA or how they compare to other drugs.

The aim of the study was to evaluate these measures in type 2 diabetes GLP-1RA users with obesity and compare them against the users of other glucose-lowering agents. It is important to understand trends in diabetes prescriptions to identify issues that can be addressed to improve treatment outcomes.

What was learned from the study?

Under real-life conditions, persistence at 2 years with GLP-1RA was low compared to other glucose-lowering agents (48.4% versus 72.7%, p < 0.0001). Among HbA1c-tested GLP-1RA users, a greater proportion of 2-year-persistent individuals showed improved glycaemic control (40.5% versus 18.6%, respectively, p < 0.0001); however, no differences in cardiovascular outcomes or all-cause death were found between 2-year-persistent and non-persistent individuals. Therapeutic inertia was found in 38.0% of the whole study population.

Strategies to reinforce medication adherence, persistence and treatment intensification for patients with type 2 diabetes should be made a priority in order to achieve and maintain therapeutic goals and improve outcomes.