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Glucose-Lowering Medication Use in T2D and HF

Am Heart J; ePub 2018 Jun 15; Arnold, et al

One-fourth of adults with type 2 diabetes (T2D) had a diagnosis of heart failure (HF) in a large US-based outpatient study, and although certain T2D medication use in patients with HF appeared consistent with evidence (less use of thiazolidinediones [TZD]), others appeared contrary to evidence, with less use of metformin and SGLT2 inhibitors. Researchers used data from the diabetes collaborative registry (DCR) of adults with diabetes and also 3,074 providers in 203 practices. They examined the relationship between concomitant HF with use of each glucose-lowering medication class, adjusting for other factors that could impact selection of 1 medication class over another: age, chronic kidney disease (CKD), coronary artery disease (CAD), number of glucose-lowering medications, and insurance. They found:

  • Among 456,106 adults with T2D, 125,161 (27%) had a diagnosis of HF (most had heart failure with preserved ejection fraction [HFpEF]).
  • Patients with T2D were more likely to be older and male, and to have CAD, atrial fibrillation (AF), and CKD.
  • HF was associated with greater use of insulin and lower use of TZD, SGLT2 inhibitors, and metformin.


Arnold SV, Echouffo-Tcheugui J, Lam CSP, et al. Patterns of glucose-lowering medication use in patients with type 2 diabetes and heart failure. Insights from the diabetes collaborative registry (DCR). [Published online ahead of print June 15, 2018]. Am Heart J. doi:10.1016/j.ahj.2018.05.016.

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