Most nursing home clinicians do not include sodium/glucose cotransporter-2 inhibitors (SGLT2Is) in their diabetes treatment toolkit, a new study has found. But use of the glucose-lowering drugs is growing in this setting, researchers report.
SGLT2Is are a relatively new class of medicines that lower blood sugar in adults with type 2 diabetes. Investigators used 100% Medicare Part D claims for long-stay nursing home residents aged 65 years and older. They compared the rate that nursing home clinicians dispensed these drugs with how often they dispensed sulfonylureas, an older class of glucose-lowering drugs.
Among more than 36,000 unique prescribers for over 117,000 residents, family medicine and internal medicine physicians accounted for most prescriptions of both drug classes (75% to 81%). In addition, 87% of clinicians prescribed only sulfonylureas, while 2% prescribed SGLT2Is only. About 11% prescribed both.
Notably, geriatricians were the physician group least likely to prescribe only SGLT2Is. But the nursing home clinicians may be warming up to the drug class. There was an uptick in use, from 2,344 in 2017 to over 5,700 in 2019, investigators found.
“Among nursing home residents, most clinicians have not incorporated SGLT2Is into their prescribing for diabetes, but the extent of use is increasing,” the researchers concluded. Provider concerns about prescribing the drugs should be a target for future study, they added.
Full findings were published in the Journal of the American Geriatrics Society.
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