New evidence highlights GLP-1 RAs' significant benefits in blood glucose and weight control for those with T2D and/or obesity, yet their real-world use and related disparities are unexplored. We conducted a pooled cross-sectional study using electronic health records from the Epic Cosmos database (2010-2023), an integrated database covering 176 million patients across 50 US states. We examined trends in GLP1-RA use among three groups: T2D-only, obesity-only, and T2D with obesity. The trend was also examined by socio-demographic factors in each group. The study included a sample of 67.9 million individuals. A gradual increase in GLP-1RA use was observed across all groups from 2010 to 2016, followed by a pronounced and accelerated uptake since 2016 (Figure). In the obesity-only population, females exhibited a 1.47 times faster uptake rate than males, measured by the annual rate of increase. Similarly, those with education beyond college showed a 1.76 times faster uptake rate than their counterparts. The utilization rate for individuals under 19 years with T2D and obesity, which remained at 0% from 2010 to 2017, surged to 35.3% in 2023. We found an upward trend in GLP-1 RA utilization since 2016 when FDA approval occurred, though use was disproportionate among some groups, raising concerns about inequitable access.
P. Li: None. J. Varghese: None. M.K. Shah: None. F.J. Pasquel: Research Support; Tandem Diabetes Care, Inc., Insulet Corporation, Dexcom, Inc., Ideal Medical Technologies, Novo Nordisk. Consultant; Dexcom, Inc., Medscape. J.L. Harding: None. T. Jiao: None. H. Shao: Consultant; Eli Lilly and Company. M.K. Ali: Advisory Panel; Eli Lilly and Company.
