Prevalence of SGLT2i and GLP1RA use among US adults with type 2 diabetes.

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Journal of diabetes and its complications


washington; spokane; Epidemiology; GLP1RA; NHANES; SGLT2i; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glucagon-Like Peptide-1 Receptor; Glucose; Humans; Hypoglycemic Agents; Male; Middle Aged; Nutrition Surveys; Prevalence; Renal Insufficiency, Chronic; Sodium-Glucose Transporter 2 Inhibitors


AIMS: To determine national prevalence of sodium-glucose contransporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP1RA) use among adults with type 2 diabetes mellitus (T2DM).

METHODS: We studied adults with T2DM and eGFR ≥ 30 mL/min/1.73 m

RESULTS: Among 1375 participants studied in 2017-2020, mean age was 60 years, 46% were women, 13% self-identified as non-Hispanic Black, 10% self-identified as Mexican American, 37% had CKD, 8.5% had CHF, and 23% had ASCVD. The prevalence of SGLT2i and GLP1RA use was 5.8% and 4.4%, respectively. Among adults with CKD, CHF, or ASCVD, SGLT2i were used by 7.7% and GLP1RA were used by 3.5%. Differences in SGLT2i or GLP1RA use were observed by age, race, ethnicity, health insurance status, body mass index, and by whether a single healthcare provider was identified as responsible for diabetes management. Biguanides, sulfonylureas, DPP-4 inhibitors, and insulin were used more frequently than SGLT2i or GLP1RA. Prevalence of SGLT2i but not GLP1RA use increased significantly from 2013-2014 to 2017-2020.

CONCLUSIONS: SGLT2i and GLP1RA use is low among adults with T2DM, including among those with strong indications. Enhanced implementation of these agents is crucial to improving kidney and cardiovascular outcomes and mitigating health disparities in T2DM.

Clinical Institute

Kidney & Diabetes