Application of 2021 American Diabetes Association Glycemic Treatment Clinical Practice Recommendations in Primary Care

We aimed to identify the proportion of primary care patients meeting criteria for sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) for cardiorenal comorbidities per 2021 ADA Clinical Practice Recommendations using readily available electronic health record (EHR) characteristics.

Research Design and Methods

We applied 2021 ADA recommendations to a primary care cohort of 13,350 adults with type 2 diabetes (T2D).

Results

Thirty-three percent of patients with diabetes would be eligible for an SGLT2i or GLP-1 RA based on cardiorenal comorbidities. Thirteen percent of patients meet criteria for SGLT2i based on heart failure or albuminuric chronic kidney disease (CKD); 18% of patients met criteria for either agent based on atherosclerotic cardiovascular disease or CKD with UACR≤300 mg/g.

Conclusions

This EHR algorithm identified one-third of primary care T2D patients as meeting criteria for SGLT2i and GLP-1 RA based on strict comorbidity definitions according to 2021 ADA recommendations.