847-P: SGLT2 Inhibitors and GLP-1s Are Falling Short of Expectations among Patients with Type 2 Diabetes Newly Initiating Therapy

Abstract

SGLT-2s and GLP-1s have demonstrated significant glucose lowering, cardiorenal, and weight loss benefits. However, the exisiting research on patients’ perception of these benefits is limited. Thus, the present study aims to identify and compare new users' expectations of SGLT-2s and GLP-1s and the degree to which their expectations have been met. In September 2022, 3,785 adults living with T2D took an online survey in which they indicated their SGLT-2 and GLP-1 usage and start date. Those who initiated SGLT-2 (n=108) or GLP-1 (n=128) use in the past year reported their expected changes upon starting the therapy. Participants were then asked the degree to which their expectations were met for each expectation held. Met expectations were calculated based on the percent of people selecting a 9 or 10 on a 10-point Likert scale. New SGLT-2 users expected lower A1c, increased protection against kidney disease, and weight loss (76%, 43%, and 40%, respectively), although less than a third of SGLT-2 new users expecting a lower A1c and weight loss felt that their expectations were met (29% and 28%, respectively). GLP-1 new users expected lower A1c, weight loss, and fewer instances of hyperglycemia (80%, 74%, and 48%, respectively). Only a third of new users felt their expectations of lower A1c and weight loss were met (34% and 33%, respectively). Expectations of A1c lowering were similar between GLP-1s and SGLT-2s (80% vs. 76%); however, weight loss expectations were significantly higher among GLP-1 users compared to those on SGLT-2s (74% vs. 43%, p<.01). Among patients initiating SGLT-2 or GLP-1 therapy, A1c lowering and weight loss expectations were not met for the majority of participants. These findings emphasize the need for improved expectation management and realistic goal setting. Future research is needed to understand how failed expectations translate into clinical outcomes and medication adherence, and to identify steps to better align patient expectations and outcomes. Disclosure C.Holleman: Employee; Close Concerns, Other Relationship; Abbott Diabetes, Eli Lilly and Company, LifeScan Diabetes Institute, Tandem Diabetes Care, Inc., Medtronic, Ascensia Diabetes Care, MannKind Corporation, dQ&A. E.Xu: Employee; dQ&A. E.Cox: Employee; dQ&A. T.L.Bristow: Employee; dQ&A.