There is considerable excitement regarding the benefits of using GLP-1RA in high risk populations (prior ASCVD), however translating evidence into practice is often delayed. We sought to assess within our safety net health system the use of GLP-1RA in type 2 diabetes in high-risk patients in order to inform future quality improvement (QI) initiatives. From Sep 2016 to Oct 2019, we identified a total of 4594 patients with diabetes and a diagnosis of ASCVD. Of these, a total of 101 patients (2%) were prescribed a GLP-1RA, while the majority (N=4493) were not. Patients prescribed a GLP-1RA were on average 60±9 years old, 44% were female, 40% Hispanic. Common co-morbidities and characteristics of patients with ASCVD who did, or did not, receive a GLP-1RA prescription are detailed in the Table. Most GLP-1RA prescriptions were generated by Primary Care (57%), Endocrinology (29%), and Cardiology (6%). The large majority of these patients (42%) received charity care from the health system. Patients receiving a GLP-1RA (compared to those that did not) were more often obese and with a diagnosis of nephropathy. Of note is that the ICD diagnoses identifying ASCVD in the medical records are substantially under-reported. Appropriate use of GLP-1RA in patients with documented ASCVD remains very low. This baseline data will guide our QI efforts and focus on implementing evidence-based use of GLP-1RA at the primary care level.


J.N. McNulty: None. U. Gunasekaran: None. I. Lingvay: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Other Relationship; Self; Novo Nordisk A/S. L. Meneghini: Advisory Panel; Self; Novo Nordisk Inc., Sanofi US. Consultant; Self; Applied Therapeutics, Sanofi US.

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