34-PUB: Prescription Pattern of SGLT-2 Inhibitors among Seniors with Type 2 Diabetes Mellitus and Chronic Kidney Disease in a Primary Care Setting

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Background: SGLT-2 inhibitors (SGLT2i) remain under-prescribed in eligible patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM), despite of its proven efficacy in renal protection. Data in geriatric population lacks. Methods: As part of a quality improvement project, this baseline cross-sectional evaluation assesses SGLT2i prescription rates in seniors (age ≥65 years old), with T2DM and CKD stages 3-4 (eGFR 20-59 mL/min/1.73 m2) at a primary care clinic (August to November 2023). Results: Eighty-one eligible patients were included, 56.8% were women. Mean (±SD) age was 81.7 ± 8.2 years old. Mean HbA1c was 7.1 ± 1.2%, and mean eGFR was 42.4 ± 10.9 ml/min/1.73m². Notably, 11% were not screened for proteinuria in the prior year, and 47.2% of screened individuals exhibited proteinuria. As shown in table 1, SGLT2i were prescribed in 40.7% of patients with CKD, but their use was significantly higher among patients with vascular disease (72.7%), heart failure (57.6%), and those requiring insulin (42.4%). Conclusion: In a primary care clinic, SGLT2i were prescribed in 40.7% of seniors with T2DM and CKD but were commonly used among patients with cardiovascular diseases and those requiring insulin. Further investigation is needed to understand this gap in knowledge and formulate a mitigation strategy to expand SGLT2i use in eligible patients. Disclosure E. Naous: None. M. Elnajjar: None. J. Alhaddad: None. A. Achkar: None. B.L. Jaber: Other Relationship; Up-To-Date. Consultant; Avania, LLC (Ad Hoc Member, Clinical Events Committee). Z. He: None.

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