The prevalence of cardiovascular disease and antidiabetes treatment characteristics among a large type 2 diabetes population in the United States

Objectives: The purpose of this study was to assess atherosclerotic cardiovascular disease (ASCVD) prevalence, antidiabetes medication usage and physician specialty encounters among individuals with type 2 diabetes mellitus (T2DM) in the United States during 2015.

Design: Retrospective, cross-sectional analysis.

Patients: Adults with T2DM in a large US administrative claims database. Patients were divided into ASCVD and non-ASCVD groups. Subgroup analyses were conducted for three age groups (18-44, 45-64 and 65+ years).

Results: Of 1 202 596 patients with T2DM, 45.2% had established ASCVD. About 40% of T2DM patients with ASCVD had visited a cardiologist during 2015, compared to 11% in the non-ASCVD group. The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose co-transporter 2 inhibitors (SGLT-2is) was low overall (<12%), and even lower in the ASCVD group (<9%). The prevalence of ASCVD was 15%, 36% and 71% in the 18-44, 45-64 and 65+ year age groups, respectively. GLP-1RA and SGLT-2i use was ≤5% in the 65+ subgroup, regardless of ASCVD status.

Conclusions: These real-world data showed a high prevalence of ASCVD among T2DM patients, and confirmed, as a baseline assessment, low use of GLP-1RAs and SGLT-2is in these at-risk patients prior to the 2017 American Diabetes Association guidelines recommending use of agents with proven cardiovascular benefits.