Category: Fellows Posters
Purpose: In the 2019 update to the Standards of Medical Care in Diabetes, the American Diabetes Association recognized that sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists have been shown to reduce the risk of chronic kidney disease progression in patients with type 2 diabetes (T2D). The objective of this study is to observe the effect of these medication classes on renal outcomes compared to other antidiabetic medications (oADMs) in a real-world setting.
Methods: This will be a retrospective study utilizing medical and pharmacy claims as well as laboratory data from an integrated delivery network in Texas. Patients eligible for inclusion will be ≥18 years of age with T2D, ≥12 months of continuous health plan enrollment, ≥1 prescription claim for either a SGLT2 inhibitor, GLP-1 agonist, or oADM filled between April 2013 and December 2018, and either the presence of albuminuria, or a reduced estimated glomerular filtration rate (eGFR) between 30 and 90 mL/min/1.73 m2 prior to initiation of the index medication. Patients with eGFR less than 30 mL/min/1.73 m2 will be excluded. Propensity scoring will be used to match patients to one of three groups according to index medication. Pairwise comparisons of patient characteristics between each group will be compared before and after matching. The primary outcome will be the change from baseline in urine albumin to creatinine ratio at least six months after initiation of the index medication. Additional outcomes to be assessed include the total change in eGFR, change in eGFR category, progression from micro- to macroalbuminuria, and doubling of serum creatinine from baseline.