GLP-1RA and SGLT2i utilization in people with type 2 diabetes with atherosclerotic cardiovascular disease (ASCVD) or at high risk of ASCVD in the Gulf Region

Feb 11, 2025Saudi medical journal

Use of GLP-1RA and SGLT2i medicines in people with type 2 diabetes and heart disease or high heart disease risk in the Gulf Region

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Abstract

41.3% of individuals with type 2 diabetes and established atherosclerotic cardiovascular disease were prescribed sodium-glucose cotransporter 2 inhibitors (SGLT2i).

A higher proportion of participants with established atherosclerotic cardiovascular disease received SGLT2i compared to glucagon-like peptide-1 receptor agonists (GLP-1RAs).
Utilization rates of GLP-1RAs and SGLT2i varied significantly across Bahrain, Kuwait, and Qatar.
In Bahrain, the lowest rates of GLP-1RA and SGLT2i use were observed at 2.3% and 18.0%, respectively.
In Kuwait, the rates were 26.9% for GLP-1RAs and 58.2% for SGLT2i, while Qatar had 10.5% and 67.1%, respectively.
Individuals with a body mass index of 30 kg/m or higher had significantly higher usage rates of both medications.

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OBJECTIVES: To provide insights into the real-world usage of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) among individuals with type 2 diabetes (T2D) from Bahrain, Kuwait, and Qatar who either had established atherosclerotic cardiovascular disease (eASCVD) or were at high risk of developing ASCVD.

METHODS: This study of 1062 adults diagnosed with T2D from Bahrain, Kuwait, and Qatar is a sub-analysis within the Prevalence and Clinical Management of Atherosclerotic Cardiovascular Diseases in Patients with Type 2 Diabetes across Countries in the Middle East and Africa (PACT-MEA) study, a noninterventional, cross-sectional study. Participants were recruited from 13 primary or secondary care facilities between March and August 2022. Medical records of participants were reviewed to extract relevant data, including demographic characteristics, eASCVD status, ASCVD risk and glucose-lowering treatment. Appropriate descriptive and inferential statistical tests were performed.

RESULTS: Among T2D participants with eASCVD, a significantly higher proportion (41.3%) received SGLT2i compared to GLP-1RA (10.5%,<0.001). There were notable variations in GLP-1RA/SGLT2i utilization across countries (<0.001): being lowest in Bahrain (2.3%/18.0%), 26.9%/58.2% in Kuwait and 10.5%/67.1% in Qatar. The use of both medications was significantly higher in individuals with body mass index (BMI) ≥30 kg/m(<0.05). p p p2

CONCLUSION: Despite these cardioprotective agents being recommended by guidelines, the study findings suggest a suboptimal use of GLP-1RA and SGLT2i in a real-world setting.

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GLP-1RA and SGLT2i utilization in people with type 2 diabetes with atherosclerotic cardiovascular disease (ASCVD) or at high risk of ASCVD in the Gulf Region

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