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Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease

 Jong Ha Baek  ;  Ye Seul Yang  ;  Seung-Hyun Ko  ;  Kyung Do Han  ;  Jae Hyeon Kim  ;  Min Kyong Moon  ;  Jong Suk Park  ;  Byung-Wan Lee  ;  Tae Jung Oh  ;  Suk Chon  ;  Jong Han Choi  ;  Kyu Yeon Hur 
 DIABETES & METABOLISM JOURNAL, Vol.46(5) : 701-712, 2022-09 
Journal Title
Issue Date
Atherosclerosis* ; Cardiovascular Diseases* / complications ; Cardiovascular Diseases* / epidemiology ; Diabetes Mellitus, Type 2* / complications ; Diabetes Mellitus, Type 2* / drug therapy ; Diabetes Mellitus, Type 2* / epidemiology ; Dipeptidyl-Peptidase IV Inhibitors* / therapeutic use ; Dipeptidyl-Peptidases and Tripeptidyl-Peptidases ; Female ; Glucose ; Heart Failure* / drug therapy ; Heart Failure* / epidemiology ; Humans ; Hypoglycemic Agents ; Prescriptions ; Republic of Korea / epidemiology ; Sodium ; Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
Asians ; Cardiovascular diseases ; Diabetes mellitus, type 2 ; Healthcare disparities ; Heart failure ; Sodium-glucose transporter 2 inhibitors
Background: To evaluate prescription trends and clinical factors of the sodium-glucose cotransporter 2 inhibitors (SGLT2i) use according to the presence of atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) in Korean patients with type 2 diabetes mellitus (T2DM).

Methods: Prescription patterns of SGLT2i use between 2015 and 2019 were determined using the Korean National Health Insurance Service database of claims.

Results: Of all patients with T2DM (n=4,736,493), the annual prescription rate of SGLT2i increased every year in patients with ASCVD (from 2.2% to 10.7%) or HF (from 2.0% to 11.1%). After the first hospitalization for ASCVD (n=518,572), 13.7% (n=71,259) of patients initiated SGLT2i with a median of 10.6 months. After hospitalization for HF (n=372,853), 11.2% (n=41,717) of patients initiated SGLT2i after a median of 8.8 months. In multivariate regression for hospitalization, older age (per 10 years, odds ratio [OR], 0.57; 95% confidence interval [CI], 0.56 to 0.57), lower household income (OR, 0.93; 95% CI, 0.92 to 0.95), rural residents (OR, 0.95; 95% CI, 0.93 to 0.97), and dipeptidyl peptidase-4 inhibitor (DPP-4i) users (OR, 0.82; 95% CI, 0.81 to 0.84) were associated with lesser initiation of SGLT2i in ASCVD. Additionally, female gender (OR, 0.97; 95% CI, 0.95 to 0.99) was associated with lesser initiation of SGLT2i in HF.

Conclusion: The prescription rate of SGLT2i increased gradually up to 2019 but was suboptimal in patients with ASCVD or HF. After the first hospitalization for ASCVD or HF, older age, female gender, low household income, rural residents, and DPP-4i users were less likely to initiate SGLT2i.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jong Suk(박종숙) ORCID logo https://orcid.org/0000-0002-5385-1373
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
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