Introduction and Objective: Clinical trials of sodium-glucose transporter 2 inhibitors (SGLT2i) in youth with type 2 diabetes (T2D) showed significant improvement in HbA1c% and fasting plasma glucose, yet there is limited real-world data on their use. This study sought to assess real-world use and effectiveness of SGLT2i medications in management of T2D in a diverse cohort of youth.Methods: This retrospective study analyzed youth prescribed a SGLT2i for management of T2D at two academic pediatric diabetes centers. Change in HbA1c, BMI, and insulin use from baseline to follow-up were evaluated for those taking SGLT2i. Wilcoxon signed-rank test and McNemar’s test were used to compare paired continuous and categorical variables, respectively.Results: A total of 82 patients with T2D (mean age 17.3 years (SD 1.9), 63% female, 13% Hispanic, 51% non-Hispanic Black, 31% non-Hispanic white, 61% with public insurance) were prescribed SGLT2i. Among the 62 (76%) reporting adherence or partial adherence at a median follow-up of 103-days, median HbA1c decreased from 8.4% to 7.3% (p<0.001). There was a significant reduction in mean BMI from baseline to follow-up (40.3 to 39.8kg/m2, p=0.02). The proportion of patients prescribed basal insulin decreased from 40% to 34% (p=0.13), and prandial insulin use decreased from 22% to 16% (p=0.06).Conclusion: Real-world use of SGLT2i in youth with T2D is associated with decreased HbA1c levels and lower BMI, and may also reduce use of insulin for youth with T2D.
M. Timkovski: None. R.M. Wolf: Research Support; Novo Nordisk, Lilly Diabetes. Advisory Panel; Uneo. Research Support; Sanofi. D. Patel: None. B. Magella: None. E.A. Brown: None. A.S. Shah: None.
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