Patterns of glucose-lowering medication use in patients with type 2 diabetes and heart failure. Insights from the Diabetes Collaborative Registry (DCR)

American Heart Journal
Suzanne V ArnoldMikhail Kosiborod

Abstract

Optimal glucose-lowering strategies in patients with both heart failure (HF) and type 2 diabetes mellitus (T2D) are not well defined, particularly as novel medication classes emerge.We sought to evaluate current patterns of glucose-lowering medication use in adults with T2D with and without HF. The DCR is a US-based outpatient registry of adults with diabetes; currently includes 3074 providers in 203 practices. We used hierarchical, modified Poisson regression models to examine the relationship between concomitant HF with use of each glucose-lowering medication class, adjusting for other factors that could impact selection of one medication class over another: age, chronic kidney disease (CKD), coronary artery disease (CAD), number of glucose-lowering medications, and insurance. Among 456,106 adults with T2D, 125,161 (27%) had a diagnosis of HF (30% HFrEF, 15%HFmrEF, 55% HFpEF). Patients with T2D and HF were more likely to be older and male, and to have CAD, atrial fibrillation, and CKD. In the multivariable models, HF was associated with a greater use of insulin (RR 1.39, 95% CI 1.36-1.42) and lower use of thiazolidinediones (RR 0.79, 95% CI 0.74-0.83), SGLT2 inhibitors (RR 0.83, 95% CI 0.79-0.89), and metformin (RR 0.84, 95% ...Continue Reading

Citations

Aug 24, 2018·Diabetes, Obesity & Metabolism·Suzanne V ArnoldMikhail Kosiborod
Jul 17, 2019·European Journal of Heart Failure·John J V McMurrayUNKNOWN DAPA-HF Committees and Investigators
Feb 12, 2021·ESC Heart Failure·Suzanne V ArnoldUNKNOWN DISCOVER investigators
Mar 7, 2021·Heart Failure Clinics·Sara Doimo, Daniela Pavan
May 7, 2021·Diabetes Research and Clinical Practice·Nebojsa M Lalic
Jun 4, 2021·Current Cardiology Reports·Ben Alencherry, Dennis Bruemmer
Jun 25, 2021·JAAPA : Official Journal of the American Academy of Physician Assistants·Rebecca ClawsonAshley Fort
Jun 15, 2021·Expert Review of Clinical Pharmacology·Theocharis KoufakisKalliopi Kotsa

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