ArticlePloS one2024
Geographic variation and racial disparities in adoption of newer glucose-lowering drugs with cardiovascular benefits among US Medicare beneficiaries with type 2 diabetes.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association of Social Determinants of Health with Utilization of SGLT2 Inhibitors and GLP1 Receptor Agonists: A Systematic Review and Meta-Analysis.Journal of general internal medicine · 2026Pooled it
- Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People.Diabetes care · 2025Trial
- Receipt of glucagon-like peptide-1 receptor agonists among rural patients with obstructive sleep apnea and excess weight.Annals of the American Thoracic Society · 2026Article
- Adherence to GLP-1 receptor agonists and SGLT2 inhibitors by out-of-pocket spending among Medicare beneficiaries with diabetes.Diabetes, obesity & metabolism · 2025Article
- Management of Type 2 Diabetes Mellitus in Native Americans and Alaska Natives: A Systematic Review.Journal of racial and ethnic health disparities · 2025Review
- Health Disparity Clusters of Off Label Prescriptions for Glucagon-Like Peptide 1 Receptor Agonists.American journal of medicine open · 2025Article
- Factors and Disparities Influencing Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-like Peptide 1 Receptor Agonists Initiation in the United States: A Scoping Review of Evidence.Pharmacy (Basel, Switzerland) · 2025Review
- Structural factors and their influence on the use of novel antidiabetic agents: Making the case for increased awareness and access to clinical pharmacy services.Journal of the American College of Clinical Pharmacy : JACCP · 2025Article
- Antiretroviral Therapy Use and Disparities Among Medicare Beneficiaries with HIV.Journal of general internal medicine · 2024Observational
- Social and Structural Determinants of Cardiovascular Complications of Diabetes.Current diabetes reports · 2024Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundPrior studies have shown disparities in the uptake of cardioprotective newer glucose-lowering drugs (GLDs), including sodium-glucose cotranwsporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1a). This study aimed to characterize geographic variation in the initiation of newer GLDs and the geographic variation in the disparities in initiating these medications.
methodsUsing 2017-2018 claims data from a 15% random nationwide sample of Medicare Part D beneficiaries, we identified individuals diagnosed with type 2 diabetes (T2D), who had ≥1 GLD prescriptions, and did not use SGLT2i or GLP1a in the year prior to the index date,1/1/2018. Patients were followed up for a year. The cohort was spatiotemporally linked to Dartmouth hospital-referral regions (HRRs), with each patient assigned to 1 of 306 HRRs. We performed multivariable Poisson regression to estimate adjusted initiation rates, and multivariable logistic regression to assess racial disparities in each HRR.
resultsAmong 795,469 individuals with T2D included in the analyses, the mean (SD) age was 73 (10) y, 53.3% were women, 12.2% were non-Hispanic Black, and 7.2% initiated a newer GLD in the follow-up year. In the adjusted model including clinical factors, compared to non-Hispanic White patients, non-Hispanic Black (initiation rate ratio, IRR [95% CI]: 0.66 [0.64-0.68]), American Indian/Alaska Native (0.74 [0.66-0.82]), Hispanic (0.85 [0.82-0.87]), and Asian/Pacific islander (0.94 [0.89-0.98]) patients were less likely to initiate newer GLDs. Significant geographic variation was observed across HRRs, with an initiation rate spanning 2.7%-13.6%.
conclusionsThis study uncovered substantial geographic variation and the racial disparities in initiating newer GLDs.
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