Visual Abstract
There is limited published evidence on population-level use of AHA among patients (pts) ≥65 years with T2D and CVD or CV risk factors in the US. Pts ≥65 years with T2D and CVD/CV risk factors and continuous enrollment in a Medicare Advantage and Prescription plan were identified from claims (Humana Research Database) between 2015 and 2019. The CVD/CV risk cohorts included pts with ≥1 claim with CVD/CV risk factors after T2D diagnosis date (same or subsequent years) between 2015 and 2019. The CV risk cohort did not have any CVD diagnosis prior to inclusion and were included until diagnosed with CVD. For both cohorts, pts were continuously enrolled during the calendar year being evaluated. CVD and CV risk cohorts included 477,801 and 661,550 pts respectively. During the study period, in both cohorts, the use of cardioprotective AHA classes (GLP-1 RAs and SGLT-2is) was <5%. Pts receiving cardioprotective GLP-1 RAs increased from 1.2% and 1.5% in 2015 to 3.8% and 4.1% in 2019 for the CVD and CV risk cohorts, respectively. Similarly, pts receiving SGLT-2is increased from 1.1% and 1.4% in 2015 to 3.4% and 3.7% in 2019 for the CVD and CV risk cohorts, respectively. Recent 2020 ADA guidelines recommend GLP-1 RAs and SGLT-2is for pts with T2D with CVD/high CV risk; although increasing slightly, their use in older pts remained <5% in 2019. This highlights the need for better CV management with recommended therapies.
R. Mody: Employee; Self; Eli Lilly and Company. S. Cowburn: None. M. Yu: Employee; Self; Lilly Diabetes, Employee; Spouse/Partner; LifeLabs, Stock/Shareholder; Self; Lilly Diabetes, Stock/Shareholder; Spouse/Partner; Lilly Diabetes. R. Nair: Employee; Self; Humana. M. Konig: Employee; Self; Eli Lilly and Company. T. G. Prewitt: None.
