Achievement of HbA1c and weight targets in adults with type 2 diabetes on once weekly injectable glucagon-like peptide-1 receptor agonist therapy in UK primary care: A retrospective, real-world study.

Abstract

Aims: Evaluate glycated haemoglobin (HbA1c) and weight changes after 6 months of once-weekly (QW) injectable glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in UK primary care.

Materials and methods: Retrospective, non-interventional study, using the Clinical Practice Research Datalink Aurum primary care database, identified adults with type 2 diabetes (T2D) newly initiating a QW injectable GLP-1 RA between January 2020 and November 2021. Dual primary outcomes were proportion of patients with (1) HbA1c < 7% (<53 mmol/mol) and (2) weight loss categories (from 0% to 15+%) after 6 months of continuous GLP-1 RA therapy.

Results: The study cohort comprised 10 816 adults: mean ± standard deviation age 58.8 ± 11.4 years, baseline HbA1c 9.3% ± 1.7% (78.1 ± 18.6 mmol/mol) and body mass index 36.6 ± 7.2 kg/m². Of 5236 patients with data, 32.8% achieved HbA1c < 7% after 6 months; this proportion was higher for time since T2D diagnosis <5 years (34.1%) versus longer disease duration: ≥5-<10 years (28.0%), ≥10-<15 years (18.7%) and ≥15 years (19.3%). Of 3963 patients with weight data, 22.0% did not lose weight; 34.0%, 27.0%, 11.4% and 5.6% achieved weight reductions of >0%-<5%, ≥5%-<10%, ≥10%-<15% and ≥15%, respectively. No major differences in weight loss were observed by diabetes duration.

Conclusions: Two thirds of T2D patients receiving QW injectable GLP-1 RA for 6 months did not attain target HbA1c < 7%, and less than half and one-quarter of patients achieved ≥5% and ≥10% weight loss, respectively. Results suggest an unmet need for better clinical management of T2D in UK primary care.