Diabetes Unit, Massachusetts General Hospital, Boston, MA
Harvard Medical School, Boston, MA.
Diabetes Care. 2021 Jun;44(6):1443-1446. doi: 10.2337/dc21-0013. Epub 2021 May 20.
We aimed to identify the proportion of primary care patients meeting criteria for sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for cardiorenal comorbidities per 2021 American Diabetes Association (ADA) Standards of Care recommendations using readily available electronic health record (EHR) characteristics.
We applied 2021 ADA recommendations to a primary care cohort of 13,350 adults with type 2 diabetes (T2D).
We found that 33% of patients with diabetes would be eligible for an SGLT2i or GLP-1 RA based on cardiorenal comorbidities, 13% of patients met criteria for an SGLT2i based on heart failure or albuminuric chronic kidney disease (CKD), and 18% of patients met criteria for either agent based on atherosclerotic cardiovascular disease or CKD with an albumin-to-creatinine ratio of ≤300 mg/g.
This EHR algorithm identified one-third of primary care patients with T2D as meeting criteria for SGLT2i and GLP-1 RA based on strict comorbidity definitions according to 2021 ADA recommendations.
我们旨在根据 2021 年美国糖尿病协会(ADA)标准护理建议,通过易于获得的电子健康记录(EHR)特征,确定符合钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2is)和胰高血糖素样肽 1 受体激动剂(GLP-1 RAs)用于治疗心血管和肾脏合并症标准的初级保健患者比例。
我们将 2021 年 ADA 建议应用于 13350 名患有 2 型糖尿病(T2D)的初级保健患者队列。
我们发现,根据心血管和肾脏合并症,33%的糖尿病患者有资格使用 SGLT2i 或 GLP-1 RA,13%的患者因心力衰竭或白蛋白尿性慢性肾脏病(CKD)符合 SGLT2i 标准,18%的患者因动脉粥样硬化性心血管疾病或白蛋白与肌酐比值≤300mg/g 的 CKD 符合任一药物标准。
根据 2021 年 ADA 建议的严格合并症定义,该 EHR 算法确定了三分之一的 T2D 初级保健患者符合 SGLT2i 和 GLP-1 RA 的标准。