Real‐world treatment trajectories preceding GLP ‐1 receptor agonist initiation in type 2 diabetes: A descriptive UK population‐based cohort study on adherence to national clinical guidelines
Authors' conclusion
GLP-1RAs were predominantly initiated following ≥3 glucose-lowering agents, consistent with contemporary UK guidance (NG28). Post-2018, most GLP-1RA initiators received SGLT-2is concomitantly. However, CVD history did not influence prescribing patterns, underscoring missed opportunities to optimise the prevention of cardiovascular events and slow the progression of CVD.
Study context
- Population
- Adults with T2D initiating GLP-1RAs in UK primary care, 01 January 2007 to 30 June 2023GLP-1RA initiators
- Participants
- 29,780 adults
- Exposure
- Pre-2018 vs Post-2018
- Pre-2018n = 18,517
- Post-2018n = 11,263
- Outcome
- Glucose-lowering treatment trajectories from first therapy to GLP-1RA initiation
Methodological detailsUK primary care, IQVIA Medical Research Data (IMRD)
- UK primary care
- IQVIA Medical Research Data (IMRD)
Main finding
As reported in the abstract
Line of therapy at first GLP-1RA
- Fourth-line or later-line therapy
- 63.5%
- Fourth-line
- 35.4%
- Later-line
- 28.1%
- First-line
- 0.8%
- Second-line
- 10.5%
- Third-line
- 25.2%
Observational data: associations, not effects.
Further findings
Concomitant SGLT2i use at GLP-1RA initiation, post-2018
- Overall
- 50.8%
- Established cardiovascular disease (CVD)
- 47.8%
- Without CVD
- 51.5%
- Regardless of CVD status
GLP-1RA as first-, second- or third-line treatment by body mass index (BMI)
- BMI ≥35 kg/m²
- 46.3%
- BMI <35 kg/m²
- 29.1%
- BMI ≥35 kg/m² initiated GLP-1RA earlier
Original publication
Real‐world treatment trajectories preceding GLP ‐1 receptor agonist initiation in type 2 diabetes: A descriptive UK population‐based cohort study on adherence to national clinical guidelines. Diabetes Obes Metab. Published 25 February 2026. doi:10.
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