Newer Glucagon-Like Peptide-1 Receptor Agonists Are Associated With Improved Glycemic Control in US Adults With Type 2 Diabetes: A Population-Level Time Series Analysis

Objectives The population-level impact of newer glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatments on patients with type 2 diabetes remains unclear. Therefore, this study investigated the association of newer GLP-1 RAs with population-level diabetes-related outcomes in US adults with type 2 diabetes. Methods This was a noninterventional, retrospective analysis of administrative insurance claims data obtained from Optum’s deidentified Clinformatics® Data Mart Database between January 2004 and December 2022. Individual patient data were aggregated into monthly time series at the population level. Associations between the proportion of patients on newer GLP-1 RAs of interest (dulaglutide, once-weekly or oral semaglutide, and tirzepatide) and average hemoglobin A1c (HbA1c), HbA1c <7.0%, and HbA1c <8.0% were assessed using time series regressions. Time-based trends in population-level outcomes were assessed using interrupted time series analyses. All analyses were adjusted for potential confounders. Results Time series regression analyses demonstrated that a higher proportion of patients taking newer GLP-1 RAs was associated with a lower average HbA1c and a higher proportion of patients with HbA1c <7.0% (after 5 months of treatment) and <8.0% (after 2 months of treatment). Results from the interrupted time series analyses demonstrated that population-level glycemic control has been improving since the first newer GLP-1 RA (dulaglutide) was approved. This trend has persisted, even after the COVID-19 emergency declaration. Conclusions A higher percentage of patients receiving newer GLP-1 RAs was associated with significantly improved population-level glycemic control. The newer GLP-1 RA period displayed improved population-level glycemic control compared with the older GLP-1 RA period.