Evidence map›Paper›PMID 35015080›Full record

ArticleDiabetes care2022

Utilization Rates of SGLT2 Inhibitors and GLP-1 Receptor Agonists and Their Facility-Level Variation Among Patients With Atherosclerotic Cardiovascular Disease and Type 2 Diabetes: Insights From the Department of Veterans Affairs.

Dhruv Mahtta, David J Ramsey, Michelle T Lee, Liang Chen, Mahmoud Al Rifai, Julia M Akeroyd, Elizabeth M Vaughan, Michael E Matheny, Karla Rodrigues do Espirito Santo, Sankar D Navaneethan and 5 more

Open access · bronzeAbstract read
In one paragraph

Article in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 1 pooled it
16.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 1 synthesis or guideline pooled it, 121 citations in OpenAlex.

  1. Pooled it
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  19. Population Health Management for Improving Kidney Health Outcomes.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025
    Article
  20. Observational

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Dhruv MahttaSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.ORCID 0000-0003-3904-8872
David J RamseyHealth Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX.
Michelle T LeeSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Liang ChenHealth Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX.
Mahmoud Al RifaiSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Julia M AkeroydHealth Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX.
Elizabeth M VaughanDivision of General Internal Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX.
Michael E MathenyGeriatrics Research Education and Clinical Care, Tennessee Valley Healthcare System VA, Nashville, TN.
Karla Rodrigues do Espirito SantoAcademic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Sankar D NavaneethanSection of Nephrology and Institute of Clinical and Translational Research, Baylor College of Medicine, Houston, TX.
Carl J Lavie10Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA.
Yochai BirnbaumSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Christie M BallantyneSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Laura A PetersenHealth Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX.
Salim S ViraniSection of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX.ORCID 0000-0001-9541-6954
Baylor College of Medicine · USHealth Services Research & Development · USMichael E. DeBakey VA Medical Center · USHospital Israelita Albert Einstein · BRVA Tennessee Valley Healthcare System · US

Funding

Implementing Sustainable Type 2 Diabetes Care: A Hybrid Type 1 RCT to Test a Community Health Worker-Led Evidence-Based InterventionR01DK129474 · NIDDK · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Elizabeth M Vaughan · 2021 to 2026
$4.1M
Technology to improve the health of resource-poor Hispanics with diabetesK23DK110341 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI VAUGHAN, ELIZABETH M · 2017 to 2021
$857k
Improving Analysis of Endogenous Multimodal Treatments for Use in Geriatrics Health Outcomes StudiesI01HX002237 · VA · VA BOSTON HEALTH CARE SYSTEM · PI GARRIDO, MELISSA M · 2018 to 2021
–
HSRD VA I01 HX003868HSRD VA SDR 02-237NIDDK NIH HHS K23 DK110341NIDDK NIH HHS R01 DK129474
6 · The paper itself

Abstract

objectiveThere is mounting evidence regarding the cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) among patients with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus (T2DM). There is paucity of data assessing real-world practice patterns for these drug classes. We aimed to assess utilization rates of these drug classes and facility-level variation in their use. RESEARCH DESIGN AND

methodsWe used the nationwide Veterans Affairs (VA) health care system data set from 1 January 2020 to 31 December 2020 and included patients with established ASCVD and T2DM. Among these patients, we assessed the use of SGLT2i and GLP-1 RA and the facility-level variation in their use. Facility-level variation was computed using median rate ratios (MRR), a measure of likelihood that two random facilities differ in use of SGLT2i and GLP-1 RA in patients with ASCVD and T2DM.

resultsAmong 537,980 patients with ASCVD and T2DM across 130 VA facilities, 11.2% of patients received an SGLT2i while 8.0% of patients received a GLP-1 RA. Patients receiving these cardioprotective glucose-lowering drug classes were on average younger and had a higher proportion of non-Hispanic Whites. Overall, median (10th-90th percentile) facility-level rates were 14.92% (9.31-22.50) for SGLT2i and 10.88% (4.44-17.07) for GLP-1 RA. There was significant facility-level variation among SGLT2i use-MRRunadjusted: 1.41 (95% CI 1.35-1.47) and MRRadjusted: 1.55 (95% CI 1.46 -1.63). Similar facility-level variation was observed for use of GLP-1 RA-MRRunadjusted: 1.34 (95% CI 1.29-1.38) and MRRadjusted: 1.78 (95% CI 1.65-1.90).

conclusionsOverall utilization rates of SGLT2i and GLP-1 RA among eligible patients are low, with significantly higher residual facility-level variation in the use of these drug classes. Our results suggest opportunities to optimize their use to prevent future adverse cardiovascular events among these patients.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Sodium-Glucose Transporter 2 InhibitorsVeteransGlucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID35015080
PMCPMC8914426
OpenAlexW4205761485

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.