Analysis of the current status of SGLT-2i and GLP-1RA in patients with diabetes complicated with coronary heart disease

Objective: This study aims to investigate the current utilization status of cardiovascular-beneficial glucose-lowering agents, specifically Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP-1RA), in type 2 diabetes mellitus (T2DM) patients concurrented by coronary heart disease (CHD). Additionally, it analyzes the factors affecting the drug usage from both physician and patient perspectives, providing a theoretical basis for formulating targeted intervention strategies to optimize clinical outcomes for T2DM patients with cardiovascular diseases. Methods: A cross-sectional study was conducted to recruit physicians from the Departments of Endocrinology and Cardiology across 10 comprehensive hospitals in Xiangyang City, as well as their patients diagnosed with T2DM and CHD, during January–March 2024. Basic information, comorbidities, medication status, and reasons for medication non-adherence were collected via a questionnaire survey and electronic medical record review. Additionally, physicians’ basic information, knowledge of the aforementioned drugs, prescription preferences, and perceived barriers to medication utilization were collected. Multivariate logistic regression was performed to identify the patient and physician-related factors influencing the utilization rates of SGLT2i and GLP-1RA. Results: Among 1,332 enrolled patients, 675 (50.7%) used SGLT2i or GLP-1RA, with 603 (45.3%) using SGLT2i alone, 131 (9.8%) using GLP-1RA alone, and 59 (4.4%) using both classes of drugs. Multivariate analysis revealed that factors such as age, personal economic status, BMI, presence of heart failure, and physician's awareness of the cardiovascular protective effects of SGLT2i had significant impacts on its use (all P  < 0.05). Influencing factors for GLP-1RA usage included age, BMI, personal economic status, fasting blood glucose levels, physician’s department, hospital tier, and physician's awareness of its cardiovascular protective effects (all P  < 0.05).