Background: SGLT-2 inhibitors (SGLT2i) remain under-prescribed in eligible patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM), despite of its proven efficacy in renal protection. Data in geriatric population lacks.

Methods: As part of a quality improvement project, this baseline cross-sectional evaluation assesses SGLT2i prescription rates in seniors (age ≥65 years old), with T2DM and CKD stages 3-4 (eGFR 20-59 mL/min/1.73 m2) at a primary care clinic (August to November 2023).

Results: Eighty-one eligible patients were included, 56.8% were women. Mean (±SD) age was 81.7 ± 8.2 years old. Mean HbA1c was 7.1 ± 1.2%, and mean eGFR was 42.4 ± 10.9 ml/min/1.73m². Notably, 11% were not screened for proteinuria in the prior year, and 47.2% of screened individuals exhibited proteinuria. As shown in table 1, SGLT2i were prescribed in 40.7% of patients with CKD, but their use was significantly higher among patients with vascular disease (72.7%), heart failure (57.6%), and those requiring insulin (42.4%).

Conclusion: In a primary care clinic, SGLT2i were prescribed in 40.7% of seniors with T2DM and CKD but were commonly used among patients with cardiovascular diseases and those requiring insulin. Further investigation is needed to understand this gap in knowledge and formulate a mitigation strategy to expand SGLT2i use in eligible patients.

Disclosure

E. Naous: None. M. Elnajjar: None. J. Alhaddad: None. A. Achkar: None. B.L. Jaber: Other Relationship; Up-To-Date. Consultant; Avania, LLC (Ad Hoc Member, Clinical Events Committee). Z. He: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.