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Care"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown benefits in patients with diabetes and cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>We assessed benchmark outcomes (Hemoglobin A1c, LDL-C, and blood pressure), identified the prevalence of cardiorenal indications for SGLT2i and GLP-1RA, and compared prescribing rates of GLP1-RA and SGLT2i in those with and without cardiorenal indications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We analyzed data from January 2018\u2013June 2019 for 7168 patients with diabetes using electronic medical records from the Northern Alberta Primary Care Research Network, a regional network of the Canadian Primary Sentinel Surveillance Network (CPCSSN). Patients with and without cardiorenal comorbidities were compared using descriptive statistics and two proportion Z tests.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Hemoglobin A1c\u2009\u2264\u20097.0% was met by 56.8%, blood pressure\u2009&lt;\u2009130\/80\u2009mmHg by 62.1%, LDL-C\u2009\u2264\u20092.0\u2009mmol\/L by 45.3% of patients. There were 4377 patients on glucose lowering medications; metformin was most common (77.7%), followed by insulin (24.6%), insulin secretagogues (23.6%), SGLT2i (19.7%), dipeptidyl peptidase-4 inhibitor (19.3%), and GLP-1RA (9.4%). A quarter of patients had cardiorenal indications for SGLT2i or GLP-1RA. Use of SGLT2i in these patients was lower than in patients without cardiorenal comorbidities (14.9% vs 21.2%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05). GLP-1RA use in these patients was 4.6% compared with 11% in those without cardiorenal comorbidities (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Contrary to current evidence and recommendations, SGLT2i and GLP1-RA were less likely to be prescribed to patients with pre-existing CVD, HF, and\/or CKD, revealing opportunities to improve prescribing for patients with diabetes at high-risk for worsening cardiorenal complications.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-022-01731-w","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T03:57:58Z","timestamp":1653364678000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Underuse of cardiorenal protective agents in high-risk diabetes patients in primary care: a cross-sectional study"],"prefix":"10.1186","volume":"23","author":[{"given":"Robin","family":"Hao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Myroniuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"McGuckin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Manca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Campbell-Scherer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roseanne O.","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"issue":"12","key":"1731_CR1","doi-asserted-by":"publisher","first-page":"2669","DOI":"10.2337\/dci18-0033","volume":"41","author":"MJ Davies","year":"2018","unstructured":"Davies MJ, D\u2019Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. 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The need for written informed consent was waived by the Health Research Ethics Board - Health Panel ethics committee due to retrospective nature of the study<i>.<\/i> Sentinel and custodian participants provided the appropriate consent and\/or data sharing agreements. A waiver of explicit individual patient consent was approved for NAPCReN to collect de-identified EMR data. All methods were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"\u2022 Dr. Yeung: Personal fees from Merck, personal fees from Diabetes Canada, personal fees from Novo Nordisk, personal fees from Sanofi, grants from Astra Zeneca, grants from Allergen, outside the submitted work.\u2022 Dr. Campbell-Scherer: NOVAD (University Hospital Foundation, Novo Nordisk & Alberta Economic Development and Trade), Pfizer - Diabetes and Obesity Expert Advisory Board.\u2022 All other authors do not have any competing interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"124"}}