Introduction and Objective: Glucagon-like Peptide-1 receptor agonists (GLP1s) are comparable to insulin for the treatment of T2D and promote weight loss. There are limited data to guide GLP1 use in severely uncontrolled T2D (A1C ≥10%).Methods: We conducted a retrospective cohort study of 1,518 adults with T2D who were ordered a GLP1 or basal insulin within 3 months of an A1C ≥10%. Data were collected at 6±3 month intervals after the first drug order and up to one month after expiration of the last drug order or a medication lapse of >1 month. Subjects taking both a GLP1 and basal insulin were excluded. Comparisons were made using the Wilcoxon rank sum or signed rank tests.Results: The mean age of the cohort was 57.8±12.1 years. 49.5% of subjects were female, 43.9% were Black, 22.1% White, and 31.0% Hispanic. Subjects were followed for a median of 22.4 months. People in both the GLP1 and basal insulin groups had significantly lower A1C at the end of study, with the GLP1 group having a significantly greater A1C reduction compared to basal insulin (Table). Subjects in the GLP1 group had significant reductions in body weight and BMI compared to baseline, while those in the basal insulin group did not (Table).Conclusion: In a racially and ethnically diverse population, GLP1s may be associated with weight loss and greater A1C reduction relative to basal insulin in people with severely uncontrolled T2D.
J. Student: None. M. DSilva: None. D. Novikov: None. M. Ahmad: None. X. Lu: None. D. Yu: None. D.J. Rubin: None.
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