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Endocrinologists with greater knowledge more likely to prescribe recommended treatment for type 2 diabetes

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Endocrinologists with greater knowledge more likely to prescribe recommended treatment for type 2 diabetes

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Endocrinologists who scored highest on the American Board of Internal Medicine's Longitudinal Knowledge Assessment (LKA) were more likely to prescribe a key diabetes drug class following a treatment guidelines update compared with doctors with lower scores, according to a new study published in JAMA Network Open.

In 2019, the American Diabetes Association (ADA) updated its Standards of Care to encourage prescribing sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) for adults with type 2 diabetes who are at high risk for cardiovascular disease, heart failure or chronic kidney disease. Researchers examined how endocrinologists' prescribing patterns for these patients changed before and after the update and whether those changes varied among high- and low-scoring LKA participants.

The study found that from 2018 (the year before the guideline update) to 2022, overall SGLT2i prescribing for patients with type 2 diabetes targeted by the updated recommendations increased by 11.4 percentage points compared with patients not targeted by the recommendations. This comparative increase was 2.4 percentage points for GLP-1RA prescribing.

The increase in SGLT2i prescribing was more than 30% larger among patients treated by endocrinologists with high (top quartile) first-year LKA scores compared with those with low (bottom quartile) scores. These score differences were not associated with increases in GLP-1RA prescribing.

"These therapies can help prevent some of the most serious and costly cardiovascular and kidney complications of diabetes, including those that can lead to hospitalizations, disability and premature death.


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