Evidence map›Paper›PMID 41838266›Full record

SynthesisJournal of general internal medicine2026

Association of Social Determinants of Health with Utilization of SGLT2 Inhibitors and GLP1 Receptor Agonists: A Systematic Review and Meta-Analysis.

Nisarg Shah, Johann Alexandre Chafa Edjimbi, Melissa Daou, Alyssa A Grimshaw, Craig Gunderson, Shaili Gupta

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

6 authors.

Nisarg ShahYale School of Medicine, New Haven, CT, USA. [email protected].
Johann Alexandre Chafa EdjimbiSinai Hospital, Baltimore, MD, USA.
Melissa DaouYale School of Medicine, New Haven, CT, USA.
Alyssa A GrimshawHarvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA.
Craig GundersonYale School of Medicine, New Haven, CT, USA.
Shaili GuptaYale School of Medicine, New Haven, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1RA) reduce cardiovascular and metabolic risks in type-2 diabetes, cardiovascular disease, and obesity, yet social determinants of health (SDOH) may influence access to these therapies. We conducted a systematic review and meta-analysis to assess whether SDOH-socioeconomic status (SES), insurance status, education, geography, neighborhood deprivation-and demographic characteristics-race and sex-are associated with differential utilization of SGLT2i or GLP-1RA.

methodsSix databases (Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar) were searched through February 2025. Retrospective and cross-sectional studies reporting association between at least one SDOH and prescription of SGLT2i and/or GLP-1RA were included. The primary outcome was the adjusted odds of utilization of SGLT2i, GLP-1RA, or both drugs by SDOH categories. Meta-analyses were conducted separately for SGLT2i and GLP-1RA using random-effects models. Risk of bias was assessed using ROBINS-I.

resultsTwenty-six studies (> 14.6 million patients) were included. Low-SES patients had reduced odds of utilization (aOR 0.73; 95% CI 0.61-0.76). Medicaid (aOR 0.70; 95% CI 0.55-0.89), Medicare (0.68; 0.60-0.78), and Medicare Advantage (aOR 0.41; 95% CI 0.30-0.57) patients had lower odds than privately insured patients. Lower educational attainment (aOR 0.70; 95% CI 0.53-0.93) and rurality (aOR 0.91; 95% CI 0.87-0.95) were associated with reduced utilization. Patients in high-deprivation neighborhoods (aOR 0.80; 95% CI 0.69-0.93) had lower odds of GLP-1RA utilization. Women had lower odds of SGLT2i utilization (aOR 0.89; 95% CI 0.82-0.95), but greater odds of GLP-1RA (aOR 1.33, 1.23-1.43). Black (aOR 0.80; 95% CI 0.79-0.82) patients had reduced utilization of both drugs, while Hispanic (aOR 0.81; 95% CI 0.69-0.96), and Asian (aOR 0.49; 95% CI 0.41-0.58) patients had reduced odds of GLP-1RA. DISCUSSION: Disparities in SGLT2i and GLP-1RA utilization span SES, insurance, education, geography, neighborhood deprivation, race, and sex, potentially limiting population-level benefits and warranting interventions to improve access.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSocial Determinants of HealthSodium-Glucose Transporter 2 InhibitorsHumansLow Socioeconomic StatusSocioeconomic Disparities in HealthGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID41838266
PMCPMC13421548

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.