Introduction: Type 2 diabetes (T2D) is a common comorbidity among kidney transplant recipients (KTR) in the U.S. To date, there are no recent studies describing the use of glucose-lowering medications (GLM) in KTR. Thus, we investigated the prescribing trends of GLM among adult KTR with T2D in the U.S.
Methods: Prevalence of GLM prescriptions in adult KTR with T2D from 2014-2023 are reported from two large U.S. insurance claims databases (Optum Clinformatics and MarketScan).
Results: We identified 64,611 adult KTR with T2D. The mean age was 60.2±12.1 years, and 61.2% were male. The mean number of GLM used was 2.8±4.2 per patient. Insulin was the most prescribed GLM, but the trend declined from 59.5% in 2014 to 48.9% in 2023. Similarly, sulfonylureas (SU) showed a decreasing trend over time, from 16.7% in 2014 to 9.7% in 2023. In contrast, newer GLM such as sodium glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1RA), steeply increased throughout our study period. SGLT2i use increased from 2.9% in 2020 to 11.2% in 2023 while that of GLP1RA increased from 2.3% in 2014 to 9.4% in 2021.
Conclusion: Insulin was the most prescribed GLM to KTR with T2D. However, the decline in insulin and SU was proportional to the rise in GLP1RA and off-label SGLT2i use. This trend follows with the timeline of clinical trials on SGLT2i and GLP1RA.
P. Hansrivijit: None. E. Patorno: Research Support; Boehringer-Ingelheim, Food and Drug Administration (FDA), National Institutes of Health, Patient-Centered Outcomes Research Institute. D.J. Wexler: Other Relationship; Novo Nordisk. R. Abdi: None. J.M. Paik: None.
