Use of New Diabetes Medicines

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New medicines can help manage type 2 diabetes, and most adults are eligible.

Recent guidelines recommend newer types of diabetes medications, and most Americans living with type 2 diabetes are eligible.

What Did This Study Examine?

In 2022, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) jointly released new medication recommendations for adults with type 2 diabetes. They recommended newer types of diabetes medications as first-line treatment for adults with type 2 diabetes who also have a type of heart disease called atherosclerotic cardiovascular disease (ASCVD), heart failure, kidney disease, or have a high risk for ASCVD. New research from CDC examined how many US adults with type 2 diabetes would meet the recommended criteria to use these medications, which are classified as glucagon-like peptide-1 receptor agonists (GLP-1s) and sodium-glucose cotransporter 2 inhibitors (SGLT-2s).

What’s important about this study?

This study showed that more than 8 in 10 US adults with type 2 diabetes are eligible, per updated guidelines, for new, effective diabetes medicines. These medicines are not just beneficial for blood sugar management but also help reduce risk for diabetes complications.  Taking these medicines could not only help many people improve their blood sugar levels but also help them reduce their weight, if needed, and protect their hearts and kidneys.

What are the terms to know?

  • Glucagon-like peptide-1 receptor agonists, or GLP-1s, are a type of medicine for people with diabetes. They lower blood sugar levels, can help with weight loss, and protect the heart and kidneys.
  • Sodium-glucose cotransporter-2 inhibitors, or SGLT-2s are a type of medicine for people with diabetes. Similar to GLP-1s, they lower blood sugar levels, can help with weight loss, and protect the heart and kidneys. Because GLP-1s and SGLT-2s work in different ways, they can be taken together at the same time.
  • Atherosclerotic cardiovascular disease, also known as ASCVD, is a type of heart disease where blood vessels are narrowed or damaged. This study defined people at high risk of ASCVD as being over age 55 and having 2 or more of the following risk factors: having obesity, hypertension, high cholesterol, kidney disease, and current smoking.

What were the results?

  • CDC researchers studied 1,330 nonpregnant adults between 2017 and 2020. People included in the study had type 2 diabetes and also had ASCVD, heart failure, chronic kidney disease, or a high risk of ASCVD.
  • Using the results of the study population, researchers estimate that with these new ADA and EASD guidelines, 82% of US adults with type 2 diabetes may be eligible to take a GLP-1, or SGLT-2, or both. They also estimate that almost all Medicare beneficiaries with type 2 diabetes may be eligible to take these medicines.
  • Very few US adults were taking GLP-1s or SGLT-2s during the study timeframe (2017-2020) because they were not yet approved for first-line therapy. Only 9% of those who are now eligible are taking either a GLP-1 or an SGLT-2 medication.

What is the take-home message?

GLP-1s and SGLT-2s can be effective for people with type 2 diabetes. They help to lower blood sugar levels and help protect against related diabetes risk factors, notably heart disease and kidney disease. Currently, these medicines are expensive, and cost may be a barrier for many people with type 2 diabetes. More research on cost-effectiveness can help guide diabetes interventions at a sustainable cost.

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