Onjective: Examine the relationship between timing of initiation on a glucagon-like peptide-1 receptor agonist (GLP-1 RA) and HbA1c.
Methods: The IBM MarketScan databases from 1/1/13 through 12/31/17 were used to identify adults with type 2 diabetes (T2D) who initiated on a GLP-1 RA in 2015 (first such date = index date) and had ≥1 HbA1c result in the last 6 months of the 2 year pre-period and another HbA1c in the last 6 months of the 2 year post-period. Time to GLP-1 RA initiation was proxied by the number of classes of glucose-lowering agents (GLAs) prescribed in the pre-period, with fewer GLAs indicating earlier GLP-1 RA initiation. Paired t-tests were used to examine differences in HbA1c from pre-period to post-period. Multivariable analyses examined the relationship between time to GLP-1 RA initiation and post-period HbA1c.
Results: The cohort (N=1,122) was 54% female with mean age of 55 ± 8.5 [SD] years. Initiation on a GLP-1 RA was associated with a significant reduction in HbA1c (8.5% ± 1.9% pre-period v 7.9% ± 1.8% post-period; P<0.0001). Earlier initiation on a GLP-1 RA was associated with significantly lower post-period HbA1c and a significant increase in the likelihood of a patient achieving post-period HbA1c < 7% (Figure 1).
Conclusions: Earlier initiation on a GLP-1 RA was associated with significantly lower HbA1c and an increased likelihood of achieving HbA1c < 7%.
R.E. Malik: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. R. Mody: Employee; Self; Eli Lilly and Company. M.J. Lage: Consultant; Self; Eli Lilly and Company. Consultant; Spouse/Partner; Eli Lilly and Company. K. Boye: Employee; Self; Lilly Diabetes. Stock/Shareholder; Self; Eli Lilly and Company.