Table 2.
Association between the presence of CKD and prescription of SGLT2i and GLP1-RA among VA patients with T2DM during the years 2019 and 2020
| SGLT2i prescription | GLP1-RA prescription | ||||
|---|---|---|---|---|---|
| n | % Prescribed | Multivariable model* | % Prescribed | Multivariable model* | |
| OR (95% CI) | OR (95% CI) | ||||
| CKD† | |||||
| Absent | 610,528 | 11 | Reference | 7 | Reference |
| Present | 424,680 | 12 | 0.98 (0.97, 1.00) | 10 | 1.13 (1.12, 1.15) |
| Unknown | 162,672 | 8 | 0.85 (0.81, 0.90) | 5 | 0.81 (0.75, 0.86) |
| KDIGO CKD stage‡ | |||||
| eGFR, mL/min/1.73 m2 | |||||
| G1: ≥90 | 88,959 | 16 | Reference | 11 | Reference |
| G2: 60–89 | 192,723 | 15 | 1.02 (0.99, 1.05) | 11 | 0.99 (0.94, 1.04) |
| G3a: 45–59 | 94,564 | 12 | 0.93 (0.89, 0.96) | 9 | 1.02 (0.98, 1.07) |
| G3b: 30–44 | 24,056 | 9 | 0.72 (0.69, 0.76) | 12 | 1.17 (1.11, 1.22) |
| G4:15–29 | 23,588 | 4 | 0.42 (0.39, 0.45) | 12 | 1.09 (1.03, 1.15) |
| ACR, mg/g | |||||
| A1: <30 | 125,732 | 11 | Reference | 9 | Reference |
| A2: 30–300 | 185,413 | 13 | 0.96 (0.95, 0.98) | 11 | 1.01 (0.98, 1.03) |
| A3: >300 | 71,935 | 12 | 0.91 (0.89, 0.93) | 13 | 0.97 (0.94, 1.00) |
| Unknown ACR/PCR | 41,600 | 7 | 0.76 (0.72, 0.79) | 7 | 0.80 (0.73, 0.87) |
| Nephrology visit | |||||
| No | 1,133,361 | 11 | Reference | 7 | Reference |
| Yes | 64,519 | 13 | 1.05 (1.01, 1.09) | 15 | 1.18 (1.14, 1.23) |
*
Multivariable model adjusted for age, sex, self-identified race/ethnicity, ZIP Code median income, ZIP Code area social deprivation index, VA diabetes and service connection, rurality, smoking status, unhealthy alcohol use, hypertension, BMI, mental health diagnosis, hemoglobin A1c, antidiabetes medications, endocrinology visit, cardiology visit, nephrology visit, frailty, and COVID-19 diagnosis.
†
Separate models were fitted for CKD and CKD stage.
‡
For eGFR category, models simultaneously adjust for ACR. For ACR category, models simultaneously adjust for eGFR.