LBSUN319 Characteristics And Treatment Patterns Of Hispanic/latino Patients Initiating First Injectable Glp-1ra Or Basal Insulin
Authors: Hoog Meredith , Maldonado Juan M , Halpern Rachel , Dhangar Indu , Buysman Erin , McNiff Kim , Konig Manige 
Published: November 2022

Hispanic/Latino (H/L) adults in the United States have greater prevalence of T2D and diabetes-related complications compared to non-Hispanic/Latinos (nH/L). Optimal glycemic control remains a challenge in H/L patients, resulting in poor health outcomes and substantial burden of comorbidities. Injectable treatments, such as GLP-1RA and basal insulin, are recommended treatment options for patients with T2D-related complications. However, there is limited information on H/L patients initating these treatments. This retrospective cohort study, conducted using claims data (January 2014−February 2020), described demographics, baseline clinical characteristics and treatment patterns of H/L and nH/L patients with T2D initiating first injectable GLP-1RA or basal insulin. Adult commerical or Medicare Advantage enrollees with ≥1 pharmacy claim for injectable GLP-1RA or basal insulin were included. Index date was the date of first claim for GLP-1RA or basal insulin (January 2015−August 2019); with a 6 months post-index follow-up period. Patients with any injected T2D medications during 12-month baseline period were excluded. Patients were categorized as H/L and nH/L groups from race/ethnicity data. Subsets of patients with ≥2 claims for index GLP-1RAs or ≥3 claims for basal insulin, or with baseline and follow-up A1C values, were analyzed for index medication dose escalation and A1C, respectively. Data were presented descriptively as counts and percentages for categorical variables; means and standard deviations (SD) for continuous variables. The study sample included 9,088 H/L and 52,030 nH/L patients with T2D; 46.8% and 49.5% initiated GLP-1RAs in the H/L and nH/L groups, respectively. Mean (SD) age was 58.3 (13.7) and 61.8 (12.7) years in H/L and nH/L groups, respectively. A majority of H/L (60.6%) and nH/L (52.6%) patients had commercial insurance. The most common comorbidities in H/L and nH/L were hypertension (71.5% and 79.1%), dyslipidemia (68.6% and 71.3%), and obesity (20. 0% and 22.3%), respectively. Mean baseline A1C for H/L and nH/L subset with ≥1 A1C value was 9. 04% and 8.79%, respectively; 14.3% of H/L and 16.8% of nH/L had baseline A1C &lt; 7. 0%. Dose escalation of index medication occured in 37.1% of H/L and 40. 0% of nH/L groups. Patients who discontinued index treatment were 55.4% and 47.3% of H/L and nH/L groups, respectively. Our findings suggest that demographics, comorbidities and treatment patterns varied for H/L and nH/L patients initiating a first injectable treatment. This includes a numerically lower proportion of the H/L group initiating GLP-1RA. Understanding the characteristics of H/L patients may help guide management of T2D in this high-risk population and improve treatment outcomes. Future research on optimizing treatments in H/L patients with T2D could provide additional insight and potentially prevent early manifestation of complications in this group.

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