{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:42:27Z","timestamp":1792291347125,"version":"4.4.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">SGLT\u20102 (sodium glucose transporter\u20102) inhibitors and GLP\u20101RAs (glucagon\u2010like peptide\u20101 receptor agonists) effectively lowered cardiovascular risk in large clinical trials for patients with type 2 diabetes mellitus at high risk for these complications, and have been recommended by guidelines. To evaluate the contemporary landscape in which these recommendations would be implemented, we examined the use of these medications according to clinical guideline practice.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In the National Health and Nutrition Examination Survey for 2017 to 2018, we defined compelling indications for SGLT\u20102 inhibitors by the presence of atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease, and for GLP\u20101RAs by the presence of established or high\u2010risk atherosclerotic cardiovascular disease, based on large clinical trials that have been incorporated in guideline recommendations of the American College of Cardiology and American Diabetes Association. We then evaluated use of these medications among patients with physician\u2010diagnosed type 2 diabetes mellitus. All analyses incorporated complex survey design to produce nationally representative estimates. A total 1104 of 9254 sampled individuals had type 2 diabetes mellitus, representing 10.6% (95% CI, 9.7%\u201311.6%) of the US population or 33.2\u00a0million adults nationally. Of these, 52.6% (95% CI, 47.7%\u201357.5%) had an indication for SGLT\u20102 inhibitors, 32.8% (95% CI, 28.8%\u201337.2%) for GLP\u20101RAs, and 26.6% (95% CI, 22.2%\u201331.7%) for both medications. During 2017 to 2018, 4.5% (95% CI, 2.4%\u20138.2%) were treated with SGLT\u20102 inhibitors and 1.5% (95% CI, 0.7%\u20133.2%) with GLP\u20101RAs. Atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease were not independently associated with SGLT\u20102 inhibitor or GLP\u20101RA use in patients with diabetes mellitus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite a large number of patients being eligible for guideline\u2010recommended cardiorenal protective therapies, there are substantial gaps in the use of SGLT\u20102 inhibitors and GLP\u20101RAs, limiting their public health benefits.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021084","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T18:30:05Z","timestamp":1621103405000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Contemporary National Patterns of Eligibility and Use of Novel Cardioprotective Antihyperglycemic Agents in Type 2 Diabetes Mellitus"],"prefix":"10.1161","volume":"10","author":[{"given":"Arash A.","family":"Nargesi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-6774","authenticated-orcid":false,"given":"Gini P.","family":"Jeyashanmugaraja","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Bridgeport HospitalYale\u2010New Haven Health System Bridgeport CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2384-2545","authenticated-orcid":false,"given":"Nihar","family":"Desai","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasia","family":"Lipska","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"},{"name":"Section of Endocrinology and Metabolism Department of Internal Medicine Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-127X","authenticated-orcid":false,"given":"Harlan","family":"Krumholz","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"},{"name":"Department of Health Policy and Management Yale School of Public Health New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-6199","authenticated-orcid":false,"given":"Rohan","family":"Khera","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven CT"},{"name":"Center for Outcomes Research and Evaluation Yale\u2010New Haven Hospital New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13898"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3342"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041730"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.650"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-S009"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.037"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31149-3"},{"key":"e_1_3_1_10_2","unstructured":"Centers for Disease Control and Prevention (CDC) . 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Atlanta GA: Centers for Disease Control and Prevention U.S. Department of Health and Human Services; 2020."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.021084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:15:33Z","timestamp":1715598933000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.021084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,6]]},"references-count":25,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2021,7,6]]}},"alternative-id":["10.1161\/JAHA.121.021084"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.021084","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,6]]},"assertion":[{"value":"2021-01-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e021084"}}