[F31] Examining Real-World Uptake and Effectiveness of GLP-1 RA in an Urban Population with Type-2 Diabetes

Description

Project Summary: Type 2 diabetes (T2D) affects nearly 30% of Americans aged 65 and older, with significant variation in treatment quality across healthcare settings. Recent American Diabetes Association (ADA) guidelines recommend GLP-1 receptor agonists (GLP-1 RAs) as preferred second-line agents due to their cardiovascular and weight benefits, but adoption patterns among older adults vary between healthcare settings serving different populations. This research examines differences in GLP-1 RA adoption among older adults with T2D across New York City's (NYC) public and private hospital systems following guideline changes. Aim 1 will analyze the uptake of ADA clinical guideline recommendations on GLP-1 RAs among T2D patients treated in NYC public and private hospitals, by comorbidity status. Aim 2 will use target trial emulation to assess the effect of switching from other second-line T2D medications to GLP-1 RAs on cardiovascular disease risk factors and events, versus continuing on DPP-4 inhibitors, thiazolidinediones, or sulfonylureas. Aim 3 will evaluate the extent to which weight loss mediates effects of GLP-1 RAs on cardiovascular disease risk factors and events using causal mediation analysis. The fellowship provides comprehensive training in (1) mastery of electronic health record (EHR) data structures and query, (2) advanced training in causal inference methods, (3) applications of pharmacoepidemiologic approaches using EHR data, and (4) development of scientific communication skills and career development in clinical epidemiology. The research will be conducted out of NYU Langone Health Grossman School of Medicine and combines resources from two large regional EHR networks: NYC Health + Hospitals, the public hospital system, and the INSIGHT Clinical Research Network, a network of academic medical centers, providing access to robust and distinct patient populations. This project will provide evidence on medication access patterns and comparative effectiveness of T2D treatments in older adults, directly supporting NIDDK’s mission to improve the lives of patients living with this disease. Istituzione: NEW YORK UNIVERSITY SCHOOL OF MEDICINE PI: Christian Victoria Progetto: 1F31DK146642-01A1

Sectors

Source

Source: reporter.nih.gov