PDF(Pubmed)
Abstract：
BACKGROUND: Recent diabetes management guidelines recommend that sodium-glucose cotransporter 2 inhibitors (SGLT2is) or glucagon-like peptide 1 receptor agonists (GLP-1RAs) with proven cardiovascular benefits should be prioritized for combination therapy in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD). This study was aimed at evaluating SGLT2i or GLP-1RA usage rates and various related factors in patients with T2DM and established CVD.
METHODS: We enrolled adults with T2DM aged ≥30 years who were hospitalized due to established CVD from January 2019 to May 2020 at 13 secondary and tertiary hospitals in Korea in this retrospective observational study.
RESULTS: Overall, 2,050 patients were eligible for analysis among 2,107 enrolled patients. The mean patient age, diabetes duration, and glycosylated hemoglobin level were 70.0 years, 12.0 years, and 7.5%, respectively. During the mean follow-up duration of 9.7 months, 25.7% of the patients were prescribed SGLT2is after CVD events. However, only 1.8% were prescribed GLP-1RAs. Compared with SGLT2i non-users, SGLT2i users were more frequently male and obese. Furthermore, they had a shorter diabetes duration but showed worse glycemic control and better renal function at the time of the event. GLP-1RA users had a longer duration of diabetes and worse glycemic control at the time of the event than GLP-1RA non-users.
CONCLUSIONS: The SGLT2i or GLP-1RA prescription rates were suboptimal in patients with T2DM and established CVD. Sex, body mass index, diabetes duration, glycemic control, and renal function were associated with the use of these agents.
METHODS: We enrolled adults with T2DM aged ≥30 years who were hospitalized due to established CVD from January 2019 to May 2020 at 13 secondary and tertiary hospitals in Korea in this retrospective observational study.
RESULTS: Overall, 2,050 patients were eligible for analysis among 2,107 enrolled patients. The mean patient age, diabetes duration, and glycosylated hemoglobin level were 70.0 years, 12.0 years, and 7.5%, respectively. During the mean follow-up duration of 9.7 months, 25.7% of the patients were prescribed SGLT2is after CVD events. However, only 1.8% were prescribed GLP-1RAs. Compared with SGLT2i non-users, SGLT2i users were more frequently male and obese. Furthermore, they had a shorter diabetes duration but showed worse glycemic control and better renal function at the time of the event. GLP-1RA users had a longer duration of diabetes and worse glycemic control at the time of the event than GLP-1RA non-users.
CONCLUSIONS: The SGLT2i or GLP-1RA prescription rates were suboptimal in patients with T2DM and established CVD. Sex, body mass index, diabetes duration, glycemic control, and renal function were associated with the use of these agents.
摘要：
■最近的糖尿病管理指南建议，对于2型糖尿病（T2DM）和已确定的心血管疾病（CVD）患者，应优先考虑具有心血管益处的钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）或胰高血糖素样肽1受体激动剂（GLP-1RAs）的联合治疗。这项研究旨在评估T2DM和已建立的CVD患者的SGLT2i或GLP-1RA使用率和各种相关因素。
在这项回顾性观察性研究中，我们招募了2019年1月至2020年5月在韩国13家二级和三级医院因心血管疾病住院的年龄≥30岁的T2DM成年人。
■总的来说，在2,107名入选患者中，有2,050名患者符合分析条件。病人的平均年龄,糖尿病持续时间，糖化血红蛋白水平为70.0岁，12.0年,和7.5%，分别。在9.7个月的平均随访期间，25.7%的患者在CVD事件后服用SGLT2is。然而,只有1.8%的患者服用了GLP-1RAs.与SGLT2i非用户相比，SGLT2i使用者更常见的是男性和肥胖。此外，他们的糖尿病病程较短,但在事件发生时血糖控制较差,肾功能较好.与GLP-1RA非使用者相比，GLP-1RA使用者在事件发生时的糖尿病持续时间更长，血糖控制更差。
■在T2DM和已确诊的CVD患者中，SGLT2i或GLP-1RA处方率并不理想。性,身体质量指数,糖尿病持续时间，血糖控制,肾功能与这些药物的使用有关。
在这项回顾性观察性研究中，我们招募了2019年1月至2020年5月在韩国13家二级和三级医院因心血管疾病住院的年龄≥30岁的T2DM成年人。
■总的来说，在2,107名入选患者中，有2,050名患者符合分析条件。病人的平均年龄,糖尿病持续时间，糖化血红蛋白水平为70.0岁，12.0年,和7.5%，分别。在9.7个月的平均随访期间，25.7%的患者在CVD事件后服用SGLT2is。然而,只有1.8%的患者服用了GLP-1RAs.与SGLT2i非用户相比，SGLT2i使用者更常见的是男性和肥胖。此外，他们的糖尿病病程较短,但在事件发生时血糖控制较差,肾功能较好.与GLP-1RA非使用者相比，GLP-1RA使用者在事件发生时的糖尿病持续时间更长，血糖控制更差。
■在T2DM和已确诊的CVD患者中，SGLT2i或GLP-1RA处方率并不理想。性,身体质量指数,糖尿病持续时间，血糖控制,肾功能与这些药物的使用有关。
