Weighing Inequities: The Role of Obesity, Social Determinants of Health, with Glucagon-like Peptide-1 Receptor Agonist Use in Adults with Type 2 Diabetes in the United States

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dc.creatorCollins, Dallasen_US
dc.creatorKelly, Brittanyen_US
dc.creatorAguiniga, Ashlynen_US
dc.creatorPinnamraju, Jahnavien_US
dc.creatorSambamoorthi, Ushaen_US
dc.date.accessioned2024-04-17T12:46:28Z
dc.date.available2024-04-17T12:46:28Z
dc.date.issued2024-03-21en_US
dc.descriptionResearch Appreciation Day Award Winner - HSC College of Pharmacy, 2024 Clinical/Outcomes/Education Research Award - 2nd Placeen_US
dc.description.abstractTitle Weighing Inequities: The Role of Obesity, Social Determinants of Health, with Glucagon-like Peptide-1 Receptor Agonist Use in Adults with Type 2 Diabetes in the United States Authors Dallas Collins, Brittany Kelly, Ashlyn Aguiniga, Jahnavi Pinnamraju, Usha Sambamoorthi Abstract Background Glucagon-like peptide-1 receptor agonists (GLP-1) contribute to glycemic control and weight loss in patients with type 2 diabetes mellitus (T2DM). Although obesity is an important determinant of GLP-1 use, research studies have suggested racial, ethnic, and socioeconomic inequities in GLP-1 use may also exist. The purpose of this study is to determine associations of obesity and social determinants of health (SDOH) with GLP-1 use in a large, nationally representative sample of US households. Methods This is a cross-sectional analysis of adults (age > 18 years) with T2DM using pooled data from multiple years of the Medical Expenditure Panel Survey (2016, 2018, and 2020). The MEPS is a nationally representative survey of civilian non-institutionalized households in the US. Diabetes was identified from both medical conditions and household files. GLP-1 use was extracted from prescription drug event files using the multum classification therapeutic sub-sub class codes. Obesity was measured using body mass index categories using the CDC standards. We restricted our analysis to adults without missing data on body mass index. Rao-Scott chi-square tests were used to assess the unadjusted associations of categorical variables with GLP-1 use. Multivariable logistic regression with survey weights was conducted to analyze the association of obesity and SDOH variables (education, poverty, health insurance, metro area, and marital status) after controlling for gender, age, and health conditions. All analyses were conducted with SAS 9.4 survey procedures. Results There were 7,298 participants representing ~27.3 million US adults with T2DM. Overall, 7.7% of adults reported using GLP-1 and 55.2% had obesity. A higher percentage of obese adults reported GLP-1 use compared to normal and underweight adults (10.2% vs. 4.2%). Those with college education had higher rates of GLP-1 use compared to those with less than high school education (10.2 vs. 4.0%). Multivariable fully adjusted logistic regression confirmed that obesity was associated with higher odds of GLP-1 use (AOR=2.44, 95% CI= 1.58-3.76 p < 0.001) and lower less than high school (AOR=0.40, 95% CI=0.25-0.62 p <0.001) and high school education (AOR=0.72, 95% CI= 0.52-0.99, p=0.0434) were associated with lower odds of GLP-1 use. Conclusion Approximately one in 14 adults used GLP-1, with obesity being an important correlate. Our study findings suggest that socioeconomic status may act as a barrier to a medication with established benefits and may contribute to exasperating inequalities in diabetes care leading to disparities in health outcomes of adults with diabetes. Cohort studies may be needed to better understand the association of SDOH with GLP-1 use.en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12503/32629
dc.language.isoen
dc.titleWeighing Inequities: The Role of Obesity, Social Determinants of Health, with Glucagon-like Peptide-1 Receptor Agonist Use in Adults with Type 2 Diabetes in the United Statesen_US
dc.typeposteren_US
dc.type.materialtexten_US

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