Trends in use of sodium-glucose cotransporter 2 inhibitors among people with type 2 diabetes following hospitalisation with heart failure: A population-based study

Aims

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a pillar of therapy among people with both type 2 diabetes (T2D) and heart failure (HF). Despite being a population at high-risk of cardio-renal events, little is known on SGLT2i uptake following hospitalisation, a key opportunity for prescribing.

Methods

Using linked administrative data, we identified adults with T2D hospitalised with HF from January 2014 to June 2021, New South Wales, Australia. We measured quarterly trends in prevalence of SGLT2i use, and factors associated with use in 2020–2021.

Results

We identified 18,932 people with T2D hospitalised with HF. We found a 13-fold increase in SGLT2i use, reaching 13.2 % by mid-2021. SGLT2i use was higher in males (adjusted odds ratio [aOR] = 1.49, 95 % confidence interval [CI]: 1.24–1.79) and people with a primary diagnosis of HF (aOR = 1.21, 95 % CI: 1.01–1.45), lower in older age groups (≥85 vs 18–64 years: aOR = 0.18, 95 % CI: 0.12–0.26), among people with increasing clinical complexity (e.g. higher Charlson Score; frailty) and chronic kidney disease (aOR = 0.60, 95 % CI: 0.48–0.75).

Conclusions

While SGLT2i use has increased among people with T2D hospitalised with HF, uptake remains low. Optimising medication use at transitions from hospital to community care may ensure clinical benefits of these medicines are realised.