1397-P: Description of Prescribing Patterns of Antihyperglycemic Medications among Racially and Ethnically Diverse Populations in the All of Us Dataset

Introduction & Objectives: Minorities living with diabetes are more likely to have poorer glycemic outcomes compared to their White counterparts. Equitable access to novel anti-hyperglycemic medications can help improve health outcomes. The purpose of this study is to determine racial and ethnic disparities in prescribing patterns of anti-diabetic medications among persons with type 2 diabetes (T2D).

Methods: Participants were drawn from the All of Us research (AoU) program. Cases of T2D were identified using pre-defined, validated phenotype algorithm. Additionally, we identified individuals with T2D who had ever had a prescription of metformin, sulfonylureas, insulin, GLP1-RA, and SGLT2i. Multivariable logistic regression was used to assess if prescription patterns differ by race and ethnicity while adjusting for sociodemographic and clinical variables.

Results: Our analytic sample included 10,016 persons with T2D. Most participants were women (56.6%), White (51.7%), and had average HbA1C of < 7% (57.2%). Blacks (aOR = 0.72, 95% CI: 0.66 - 0.79) and Hispanics (aOR = 0.81, 95% CI: 0.73 - 0.90) compared to White participants were less likely to receive GLP1-RA prescription. Additionally, Blacks were less likely to receive SGLT2i (aOR = 0.86, 95% CI: 0.78-0.96) but more likely to receive metformin (aOR = 1.33, 95% CI: 1.21-1.45). Blacks (aOR = 0.81, 95% CI: 0.74 - 0.88) and Hispanics (aOR = 0.75, 95% CI: 0.68 - 0.83) were less likely to receive insulin therapy.

Conclusions: Our findings, highlight racial and ethnic disparities in prescribing patterns. These findings provide evidence that these differences are independent of socioeconomic status and may be a factor in worse health outcomes experienced by racial minorities with T2D.