by Prateek Chopra | June 27, 2026 | Diabetes Conferences | ADA 2026
Clinical Objective
- This systematic review evaluated sociodemographic disparities in the use of SGLT2 inhibitors among adults with type 2 diabetes, heart failure, or chronic kidney disease in the United States.
Methods
- Observational studies published between 2019 and June 10, 2025, were systematically reviewed.
- Eligible studies included adults receiving SGLT2 inhibitor therapy and reporting utilization according to sociodemographic characteristics.
Study Selection
- 1,696 records were identified through title and abstract screening.
- 123 full-text articles were reviewed.
- 23 studies with model-based analyses met the inclusion criteria.
Key Findings
- Significant disparities in SGLT2 inhibitor use were observed across multiple sociodemographic factors:
- Age
- Sex
- Race
- Educational attainment
- Income level
- Insurance status
- Older adults, women, Black individuals, and those with Medicare coverage were consistently less likely to receive SGLT2 inhibitor therapy.
Potential Contributors to Disparities
- Differences in healthcare access.
- Variability in insurance coverage and co-payment structures.
- Population and healthcare system factors across studies.
Clinical Implications
- Unequal access to guideline-recommended therapies may contribute to disparities in cardiovascular and renal outcomes.
- Identifying and addressing barriers to treatment access is essential to ensure equitable delivery of evidence-based care.
Evidence from this systematic review indicates persistent sociodemographic disparities in SGLT2 inhibitor utilization across the United States. Further research is needed to better understand the drivers of these inequities and develop strategies to improve equitable access to cardio-renal protective therapies.