Table 1.
Study population
| GLP-1RA initiators | SGLT2i initiators | DPP-4i initiators | P value | |
|---|---|---|---|---|
| (n = 75,395) | (n = 58,234) | (n = 91,884) | ||
| Demographics | ||||
| Age, years, mean (SD) | 57.3 (12.9) | 59.1 (12.0) | 65.0 (12.9) | <0.001 |
| Age-group, n (%) | <0.001 | |||
| 18–44 years | 12,805 (17.0) | 6,969 (12.0) | 6,594 (7.2) | |
| 45–64 years | 38,628 (51.2) | 31,016 (53.3) | 33,855 (36.8) | |
| 65–74 years | 17,771 (23.6) | 14,663 (25.2) | 28,450 (31.0) | |
| ≥75 years | 6,191 (8.2) | 5,586 (9.6) | 22,985 (25.0) | |
| Sex, n (%) | <0.001 | |||
| Female | 43,408 (57.6) | 24,779 (42.6) | 45,149 (49.1) | |
| Male | 31,987 (42.4) | 33,455 (57.4) | 46,735 (50.9) | |
| Race/ethnicity, n (%) | <0.001 | |||
| White | 47,017 (62.4) | 35,225 (60.5) | 51,096 (55.6) | |
| Black | 11,742 (15.6) | 8,087 (13.9) | 16,468 (17.9) | |
| Hispanic | 10,148 (13.5) | 9,090 (15.6) | 14,994 (16.3) | |
| Asian | 1,761 (2.3) | 2,463 (4.2) | 4,662 (5.1) | |
| Unknown | 4,727 (6.3) | 3,369 (5.8) | 4,664 (5.1) | |
| U.S. region, n (%) | <0.001 | |||
| Midwest | 18,346 (24.3) | 13,728 (23.6) | 20,679 (22.5) | |
| Northeast | 7,153 (9.5) | 5,760 (9.9) | 12,941 (14.1) | |
| South | 41,283 (54.8) | 32,106 (55.1) | 49,480 (53.9) | |
| West | 8,613 (11.4) | 6,640 (11.4) | 8,784 (9.6) | |
| Insurance type, n (%) | <0.001 | |||
| Commercial | 45,033 (59.7) | 35,543 (61.0) | 35,233 (38.3) | |
| Medicare Advantage | 30,362 (40.3) | 22,691 (39.0) | 56,651 (61.7) | |
| Index year, n (%) | <0.001 | |||
| 2016 | 12,347 (16.4) | 11,515 (19.8) | 22,514 (24.5) | |
| 2017 | 16,887 (22.4) | 14,263 (24.5) | 25,131 (27.4) | |
| 2018 | 20,373 (27.0) | 13,877 (23.8) | 23,041 (25.1) | |
| 2019 | 25,788 (34.2) | 18,579 (31.9) | 21,198 (23.1) | |
| Clinical characteristics | ||||
| Baseline medication fills, n (%) | ||||
| None | 21,132 (28.0) | 12,393 (21.3) | 22,481 (24.5) | <0.001 |
| Metformin | 39,414 (52.3) | 37,050 (63.6) | 52,024 (56.6) | <0.001 |
| Sulfonylureas | 17,475 (23.2) | 17,276 (29.7) | 30,495 (33.2) | <0.001 |
| Thiazolidinediones | 3,615 (4.8) | 3,301 (5.7) | 4,120 (4.5) | <0.001 |
| Insulin (any) | 22,493 (29.8) | 10,522 (18.1) | 13,265 (14.4) | <0.001 |
| Basal insulin | 19,608 (26.0) | 9,107 (15.6) | 11,633 (12.7) | <0.001 |
| Bolus insulin | 11,105 (14.7) | 4,774 (8.2) | 5,253 (5.7) | <0.001 |
| Other medication(s) | 173 (0.2) | 123 (0.2) | 268 (0.3) | 0.004 |
| Treatment type, n (%) | <0.001 | |||
| First-line | 16,164 (21.4) | 7,944 (13.6) | 14,996 (16.3) | |
| Second-line | 59,231 (78.6) | 50,290 (86.4) | 76,888 (83.7) | |
| Diabetes complications count, n, mean (SD) | 1.0 (1.3) | 0.9 (1.1) | 1.2 (1.3) | <0.001 |
| Diabetes complications count, n (%) | <0.001 | |||
| 0 | 35,375 (46.9) | 28,440 (48.8) | 35,792 (39.0) | |
| 1 | 18,860 (25.0) | 15,860 (27.2) | 23,986 (26.1) | |
| 2 | 10,689 (14.2) | 7,958 (13.7) | 15,850 (17.3) | |
| 3 | 6,081 (8.1) | 3,827 (6.6) | 9,413 (10.2) | |
| ≥4 | 4,390 (5.8) | 2,149 (3.7) | 6,843 (7.4) | |
| Comorbidities, n (%) | ||||
| Retinopathy | 9,951 (13.2) | 6,571 (11.3) | 12,645 (13.8) | <0.001 |
| Nephropathy | 14,149 (18.8) | 7,677 (13.2) | 22,773 (24.8) | <0.001 |
| Neuropathy | 19,510 (25.9) | 12,457 (21.4) | 22,786 (24.8) | <0.001 |
| Peripheral vascular disease | 9,462 (12.5) | 6,415 (11.0) | 14,613 (15.9) | <0.001 |
| Dementia | 1,137 (1.5) | 530 (0.9) | 4,109 (4.5) | <0.001 |
| MI | 2,445 (3.2) | 2,277 (3.9) | 4,327 (4.7) | <0.001 |
| Heart failure | 6,453 (8.6) | 4,210 (7.2) | 11,383 (12.4) | <0.001 |
| Cerebrovascular disease | 5,829 (7.7) | 4,360 (7.5) | 11,291 (12.3) | <0.001 |
| Chronic obstructive pulmonary disease | 9,102 (12.1) | 6,052 (10.4) | 13,345 (14.5) | <0.001 |
| Cancer | 4,546 (6.0) | 3,506 (6.0) | 8,087 (8.8) | <0.001 |
| Cirrhosis | 692 (0.9) | 495 (0.9) | 1,108 (1.2) | <0.001 |
| Prior severe hyperglycemia | 449 (0.6) | 230 (0.4) | 587 (0.6) | <0.001 |
| Prior severe hypoglycemia | 545 (0.7) | 245 (0.4) | 1,208 (1.3) | <0.001 |
| Prescriber specialty, n (%) | <0.001 | |||
| Primary care | 38,021 (50.4) | 34,208 (58.7) | 56,152 (61.1) | |
| Endocrinology | 11,267 (14.9) | 6,268 (10.8) | 5,554 (6.0) | |
| Cardiology | 272 (0.4) | 842 (1.4) | 703 (0.8) | |
| Nephrology | 160 (0.2) | 131 (0.2) | 485 (0.5) | |
| Other | 11,339 (15.0) | 7,361 (12.6) | 7,807 (8.5) | |
| Unknown | 14,336 (19.0) | 9,424 (16.2) | 21,183 (23.1) | |
| HbA1c available within prior 6 months | 27,843 (36.9) | 24,189 (41.5) | 37,022 (40.3) | <0.001 |
| HbA1c level, %, median (IQR)* | 8.1 (6.7, 9.7) | 8.3 (7.3, 9.7) | 8.0 (7.1, 9.3) | <0.001 |
| HbA1c category, n (%)* | <0.001 | |||
| ≤5.6% | 1,931 (6.9) | 299 (1.2) | 588 (1.6) | |
| 5.7–6.4% | 3,936 (14.1) | 1,760 (7.3) | 3,424 (9.2) | |
| 6.5–6.9% | 2,249 (8.1) | 2,068 (8.5) | 3,806 (10.3) | |
| 7.0–7.9% | 4,890 (17.6) | 6,075 (25.1) | 10,247 (27.7) | |
| 8.0–8.9% | 4,998 (18.0) | 5,238 (21.7) | 7,956 (21.5) | |
| 9.0–9.9% | 3,705 (13.3) | 3,357 (13.9) | 4,502 (12.2) | |
| ≥10.0% | 6,134 (22.0) | 5,392 (22.3) | 6,499 (17.6) |
Baseline characteristics of adults with type 2 diabetes at the time of their first prescription fill of a GLP-1RA, SGLT2i, or DPP-4i.
*
The denominator for HbA1c values are patients with baseline HbA1c data available.