Category: Federal Forum Posters
Purpose: At this institution, GLP-1 agonists are non-formulary agents in which a Criteria for Use is employed to assess whether a Veteran qualifies for use of the medication. The Criteria for Use for GLP-1 agonists recommends concomitant use of GLP-1 agonists with basal insulin and prandial insulin may be done on a case-by-case basis in consultation with an endocrinologist/diabetes specialist. Currently, there is limited data on use of GLP-1 agonists with basal/bolus insulin. The purpose is to help guide providers at VA Illiana on how to approach complex patients on basal/bolus insulin with regards to consideration of adding GLP-1 agonists.
Methods: A retrospective chart review will be performed using electronic health records on Veterans started on a GLP-1 agonist with basal/bolus insulin regimen between 09/01/2015 and 10/30/2018. The inclusion criteria will include: adults ≥ 18 years of age, started and received GLP-1 agonist from VA Illiana, on basal and bolus insulin regimen prior to use of GLP-1 agonist, had a baseline A1C and weight documented prior to receiving GLP-1 agonist, had documented A1C and weight within six-twelve months of therapy, and documented refills processed of GLP-1 agonist. Veterans will be excluded if: discontinued GLP-1 agonist prior to completing six months of therapy, initiated on another anti-diabetic medication during use of GLP-1 agonist, did not have a follow-up A1C after six months of therapy, or were discharged from Pharmacy PACT clinic or Endocrinology clinic as a result of no-show to appointments. The primary endpoints that will be assessed are change in A1C and episodes of hypoglycemia. Secondary endpoints that will be assessed are: change in total daily dose of insulin with the addition of GLP-1 agonist, side effects experienced due to GLP-1 agonist with insulin regimen, and the change in weight after GLP-1 agonist use.
Results: Not available at this time as data collection is not complete
Conclusion: Not available at this time as data collection is not complete
Chelsea Vuu– Pharmacy Resident, VA Illiana Health Care System, Danville, IL