P8 A contemporary assessment of diabetes medication use in people with T2D and CVD: A pre-specified analysis of the Argentinian population participating in the multinational, cross-sectional CAPTURE study

Abstract

Background and aims: Recent diabetes and cardiology guidelines recommend blood glucose (BG)-lowering medications with proven cardiovascular (CV) benefit in people with type 2 diabetes (T2D) and established CV disease (CVD) or at high/very high CV risk. CAPTURE was a cross-sectional, observational study of CVD prevalence in adults with T2D across 13 countries in 2019. This pre-specified secondary analysis assessed the proportion of adults with T2D and CVD using a BG-lowering medication with an approved CV indication in Argentinian population.

Materials and methods: Detailed demographic and clinical data were collected for adults with T2D at a single, routine health visit to primary or specialist care (Dec 2018 – Sept 2019). In this analysis, participants were grouped by CVD status (no CVD, any CVD, atherosclerotic CVD [ASCVD]). BG-lowering medication use was summarised descriptively by approved CV indication status per the current (2020) FDA label and in line with ADA/EASD guidelines, as a glucagon-like peptide-1 receptor agonist (GLP-1 RA: dulaglutide, liraglutide, semaglutide) or sodium-glucose cotransporter-2 inhibitor (SGLT2i: canagliflozin, dapagliflozin, empagliflozin).

Results: Overall, of 834 patients with T2D who were enrolled in Argentina for CAPTURE, 41.5% (n=347) had CVD. The prevalence of CVD in Argentina is higher than the global weighted prevalence estimate (41.5% vs. 34.8%). 98.4% (n=821/834) of participants received ≥1 BG-lowering medication: 78.8% used a biguanide, 21.6% a dipeptidylpeptidase-4 inhibitor, 20.6% a sulphonylurea, 43.6% an insulin, 9.1% a SGLT2i, 4.8% a GLP-1 RA and 1,1% both GLP-1 RA and SGLT-2i. 12.8% of participants were prescribed
a BG-lowering medication with an approved CV indication (Figure 1), and this was similar irrespective of CVD status: 13.8% (n=67/487), 11.5% (n=40/347) and 11.5% (n=34/295) in those with no CVD, any CVD and ASCVD, respectively. SGLT2is were more frequently used than GLP-1 RAs regardless of CVD status.

Conclusion: In Argentinean population participating in CAPTURE, fewer than 1 in 7 adults with T2D received a BG-lowering medication with an approved CV indication in 2019, irrespective of CVD status. Future implementation of recent guideline updates may help improve the discrepancy with current recommendations.