Table 2.
Cox proportional hazards models for filling a new prescription for a GLP1-RA or an SGLT2i
| HR (95% CI) | P | |
|---|---|---|
| Age | 0.94 (0.94–0.94) | <0.0001 |
| Male | 1.078 (1.06–1.1) | <0.0001 |
| Year of cohort entry | ||
| 2016 | Ref | |
| 2017 | 1.455 (1.43–1.48) | <0.0001 |
| 2018 | 1.832 (1.79–1.87) | <0.0001 |
| 2019 | 2.275 (2.23–2.33) | <0.0001 |
| Race/ethnicity | ||
| Non-Hispanic White | Ref | |
| Non-Hispanic Black | 0.810 (0.79–0.83) | <0.0001 |
| Hispanic | 0.989 (0.95–1.03) | 0.6104 |
| Asian | 1.034 (0.99–1.08) | 0.1263 |
| Other | 0.874 (0.79–0.97) | 0.0112 |
| Missing | 1.032 (0.99–1.07) | 0.093 |
| SDI, per SD28 | 0.964 (0.96–0.97) | <0.0001 |
| Region | ||
| South | Ref | |
| Northeast | 0.935 (0.92–0.96) | <0.0001 |
| Midwest | 0.815 (0.80–0.83) | <0.0001 |
| West | 1.064 (1.04–1.09) | <0.0001 |
| Comorbidities | ||
| Hypertension | 1.053 (1.02–1.08) | 0.0004 |
| Hyperlipidemia | 1.105 (1.08–1.13) | <0.0001 |
| Atrial fibrillation/flutter | 0.945 (0.92–0.97) | <0.0001 |
| Obesity | 1.377 (1.35–1.40) | <0.0001 |
| Cirrhosis | 0.852 (0.80–0.91) | <0.0001 |
| NAFLD, hepatosteatosis | 1.236 (1.19–1.28) | <0.0001 |
| Tobacco use | 0.869 (0.83–0.91) | <0.0001 |
| Alcohol use | 0.845 (0.78–0.91) | <0.0001 |
| Diabetes complications | ||
| Neuropathy | 1.225 (1.20–1.25) | <0.0001 |
| Retinopathy | 1.179 (1.15–1.20) | <0.0001 |
| Nephropathy | 1.151 (1.12–1.19) | <0.0001 |
| Comorbidity indices | ||
| Gagne index | 0.980 (0.98–0.98) | <0.0001 |
| Frailty index | 0.802 (0.61–1.05) | 0.1129 |
| SGLT2i contraindications | ||
| Diabetic ketoacidosis | 1.173 (1.00–1.37) | 0.0487 |
| Urinary tract infection | 0.956 (0.93–0.98) | 0.0002 |
| Cellulitis of the groin or Fournier gangrene | 1.384 (1.31–1.46) | <0.0001 |
| Nontraumatic amputation | 0.961 (0.87–1.06) | 0.4309 |
| Hypotension | 0.924 (0.88–0.96) | 0.0004 |
| Falls | 0.992 (0.96–1.03) | 0.6466 |
| Fracture | 1.002 (0.98–1.03) | 0.8928 |
| GLP1-RA contraindications | ||
| Pancreatitis | 0.896 (0.82–0.98) | 0.0185 |
| Cholelithiasis, cholecystitis | 0.844 (0.80–0.89) | <0.0001 |
| Medullary thyroid cancer | 1.374 (0.34–5.49) | 0.6532 |
| SGLT2i and GLP1-RA relative contraindication | ||
| Chronic kidney disease, stage 4 | 0.998 (0.98–1.02) | 0.8524 |
| Diabetes medications | ||
| Metformin | 1.421 (1.38–1.46) | <0.0001 |
| Sulfonylureas | 1.593 (1.54–1.64) | <0.0001 |
| Meglitinides | 1.509 (1.42–1.60) | <0.0001 |
| DPP-4 inhibitors | 1.867 (1.82–1.92) | <0.0001 |
| Thiazolidinediones | 1.432 (1.38–1.49) | <0.0001 |
| α-Glucosidase inhibitors | 1.397 (1.27–1.54) | <0.0001 |
| Amylin analogs | 1.590 (1.04–2.44) | 0.034 |
| Basal insulins | 1.707 (1.65–1.77) | <0.0001 |
| Bolus insulins | 1.163 (1.12–1.21) | <0.0001 |
| Mixed insulins | 1.378 (1.31–1.45) | <0.0001 |
| Cardiovascular medications | ||
| β-Blockers | 1.028 (1.01–1.04) | 0.0009 |
| ACE inhibitors, ARBs | 1.038 (1.02–1.06) | <0.0001 |
| Mineralocorticoid receptor antagonists | 1.037 (1.01–1.07) | 0.0105 |
| Sacubitril | 1.373 (1.25–1.51) | <0.0001 |
| Thiazide diuretics | 0.931 (0.91–0.95) | <0.0001 |
| Loop diuretics | 0.986 (0.97–1.01) | 0.1662 |
| Calcium channel blockers | 0.893 (0.88–0.91) | <0.0001 |
| Statins | 1.010 (0.99–1.03) | 0.2839 |
| Ezetimibe | 1.177 (1.14–1.22) | <0.0001 |
| PCSK9 inhibitors | 1.873 (1.68–2.09) | <0.0001 |
| Fibrates | 1.079 (1.05–1.11) | <0.0001 |
| Niacin | 0.908 (0.83–1.00) | 0.0469 |
| n-3 formulations | 1.420 (1.36–1.48) | <0.0001 |
| Bile acid sequestrants | 1.158 (1.09–1.23) | <0.0001 |
| Use measures | ||
| Primary care visits, per SD (5 visits) | 0.984 (0.98–0.99) | 0.0001 |
| Endocrine visits | 1.062 (1.06–1.07) | <0.0001 |
| Cardiology visits | 1.024 (1.02–1.03) | <0.0001 |
| ER visits | 0.976 (0.97–0.99) | <0.0001 |
| Hospitalizations | 0.867 (0.85–0.88) | <0.0001 |
| Total prescriptions | 1.063 (1.05–1.07) | <0.0001 |
| Total diabetes prescriptions | 1.100 (1.07–1.13) | <0.0001 |
Full model (model 4) is adjusted for demographic characteristics, comorbidities, medication use, race/ethnicity, SDI, and health care use measures. ARB, angiotensin II receptor blocker; DPP-4, dipeptidyl peptidase 4; ER, emergency room; NAFLD, nonalcoholic fatty liver disease; PCSK9, proprotein convertase subtilisin/kexin type 9; Ref, reference.