Adherence
New antidiabetic drugs with cardiovascular effects (GLP-1ra and SGLT2-in) are underutilized in primary care due to clinical inertia driven by physician uncertainty, guideline complexity, and patient-specific barriers, despite proven efficacy in reducing cardiovascular morbidity and mortality.
For family physicians managing T2D, prioritize prescribing GLP-1 receptor agonists (GLP-1ra) or SGLT2 inhibitors (SGLT2-in) for patients with established cardiovascular disease, heart failure, or chronic kidney disease, regardless of HbA1c levels. Address clinical inertia by using clinical decision support tools and clear guidelines that define specific indications for these drugs. Discuss cost and side effects (e.g., GI issues for GLP-1ra, genital infections for SGLT2-in) openly with patients to improve adherence.
Despite the proven efficacy of novel antidiabetic drugs in reducing CV morbidity and mortality in T2D patients, their prescription rates remain low in many countries and across clinical disciplines [17].
Why this rating
Opinion paper citing multiple CV outcome trials (CVOTs) and observational data; strong evidence for efficacy, weaker for the specific causal analysis of inertia.
Source
The Reasons for the Low Uptake of New Antidiabetic Drugs with Cardiovascular Effects—A Family Doctor Perspective
Tomislav Kurevija et al. · Journal of Clinical Medicine · 2024
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