Prescribing Paradigm Shift? Applying the 2019 European Society of Cardiology–Led Guidelines on Diabetes, Prediabetes, and Cardiovascular Disease to Assess Eligibility for Sodium–Glucose Cotransporter 2 Inhibitors or Glucagon-Like Peptide 1 Receptor Agonists as First-Line Monotherapy (or Add-on to Metformin Monotherapy) in Type 2 Diabetes in Scotland

Of the 265,774 people with type 2 diabetes in Scotland, 80,830 (30.4%) are estimated to require initiation of sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide 1 receptor agonists based on new guidelines.

• 20.0% of individuals with type 2 diabetes were drug naïve, while 21.4% were on metformin monotherapy.
• 74.5% of drug-naïve individuals and 72.4% of those on metformin were classified as at least high risk for cardiovascular disease.
• The guidelines recommend initiating SGLT-2 inhibitors or GLP-1 receptor agonists for all high or very high-risk patients, regardless of blood sugar levels.
• The implementation of these guidelines could have a significant impact on drug budgets and clinical monitoring in Scotland.

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