The prevalence of cardiovascular disease and antidiabetes treatment characteristics among a large type 2 diabetes population in the United States

OBJECTIVES: The purpose of this study was to assess atherosclerotic cardiovascular disease (ASCVD) prevalence, antidiabetes medication usage and physician specialty encounters among individuals with type 2 diabetes mellitus (T2DM) in the United States during 2015. DESIGN: Retrospective, cross‐sectional analysis. PATIENTS: Adults with T2DM in a large US administrative claims database. Patients were divided into ASCVD and non‐ASCVD groups. Subgroup analyses were conducted for three age groups (18‐44, 45‐64 and 65+ years). RESULTS: Of 1 202 596 patients with T2DM, 45.2% had established ASCVD. About 40% of T2DM patients with ASCVD had visited a cardiologist during 2015, compared to 11% in the non‐ASCVD group. The use of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and sodium‐glucose co‐transporter 2 inhibitors (SGLT‐2is) was low overall (<12%), and even lower in the ASCVD group (<9%). The prevalence of ASCVD was 15%, 36% and 71% in the 18‐44, 45‐64 and 65+ year age groups, respectively. GLP‐1RA and SGLT‐2i use was ≤5% in the 65+ subgroup, regardless of ASCVD status. CONCLUSIONS: These real‐world data showed a high prevalence of ASCVD among T2DM patients, and confirmed, as a baseline assessment, low use of GLP‐1RAs and SGLT‐2is in these at‐risk patients prior to the 2017 American Diabetes Association guidelines recommending use of agents with proven cardiovascular benefits.