Impact of Hospitalization on Continuation of SGLT2 Inhibitors and GLP-1 Receptor Agonists for Comorbidities in Patients with Type 2 Diabetes.

Abstract

Purpose: In the treatment of type 2 diabetes mellitus (T2DM), select sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are recommended based on comorbidities such as chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). Because guidelines typically recommend insulin for inpatient treatment of T2DM, there is potential that these therapies may be negatively impacted by hospitalization. This study aimed to assess the effect of hospitalization on outpatient T2DM therapy. Methods: In this retrospective study, patients were included if they had a diagnosis of T2DM plus a comorbidity (CKD, HF, ASCVD) for which they were prescribed an SGLT2 inhibitor or GLP-1 receptor agonist and had a recent hospitalization and follow-up appointment at an outpatient clinic. Electronic medical records were reviewed to determine if these therapies were continued during transitions of care. Data was analyzed with basic descriptive statistics. Results: Thirty-six patients on SGLT2 inhibitor therapy met inclusion criteria. Four (11%) patients were never restarted on therapy outpatient following hospitalization, three of which did not have an appropriate reason for discontinuation. Twenty-two patients on GLP-1 receptor agonist therapy met inclusion criteria. Four (18%) were never restarted on therapy outpatient following hospitalization, two of which did not have an appropriate reason for discontinuation. Conclusion: Five out of 58 patients (8.6%) included in the study experienced an inappropriate discontinuation of therapy throughout the transitions of care process. While most patients had their T2DM medication restarted, this study shows hospitalization can impact guideline-directed outpatient therapy.