Predictors of sodium–glucose cotransporter 2 inhibitor use in eligible adults with chronic kidney disease and diabetes*
| Variable | Crude OR (95% CI) | Adjusted OR† (95% CI) |
|---|---|---|
| Sociodemographic characteristics | ||
| Sex, female | 0.56 (0.52–0.59) | 0.75 (0.70–0.80) |
| Age, yr | ||
| ≤ 44 | 0.22 (0.17–0.30) | 0.61 (0.45–0.82) |
| 45–54 | 0.84 (0.75–0.94) | 1.08 (0.95–1.24) |
| 55–64 (Ref.) | 1.00 | 1.00 |
| 65–74 | 0.82 (0.76–0.88) | 0.79 (0.73–0.85) |
| 75–84 | 0.34 (0.31–0.37) | 0.39 (0.35–0.42) |
| ≥ 85 | 0.08 (0.07–0.09) | 0.13 (0.11–0.16) |
| Rural residence | 0.94 (0.87–1.02) | 0.92 (0.81–1.00) |
| Neighbourhood income quintile | ||
| 1 | 0.91 (0.83–0.99) | 0.82 (0.74–0.91) |
| 2 | 0.96 (0.88–1.06) | 0.93 (0.84–1.03) |
| 3 | 1.00 (0.91–1.10) | 0.94 (0.85–1.04) |
| 4 | 1.04 (0.95–1.15) | 0.98 (0.88–1.08) |
| 5 (Ref.) | 1.00 | 1.00 |
| Comorbidities and diabetes | ||
| Heart failure | 0.68 (0.63–0.74) | 0.84 (0.77–0.93) |
| Coronary artery disease | 1.24 (1.16–1.33) | 1.24 (1.16–1.33) |
| Stroke | 0.75 (0.69–0.80) | 0.91 (0.84–0.99) |
| Elixhauser Comorbidity Index (per 5 units) | 0.92 (0.90–0.93) | 0.92 (0.90–0.93) |
| HbA1c, % | ||
| ≤ 7.0 | 0.19 (0.17–0.20) | 0.24 (0.23–0.26) |
| > 7.0 and ≤ 9.0 (Ref.) | 1.00 | 1.00 |
| > 9.0 | 1.11 (1.03–1.20) | 0.92 (0.85–1.00) |
| Insulin | ||
| Basal insulin only | 4.60 (4.29–4.94) | 1.96 (1.81–2.12) |
| Bolus ± basal insulin | 3.12 (2.91–3.35) | 1.19 (1.10–1.29) |
| Health care utilization in the previous year | ||
| Family physician visits | ||
| No family physician visits (Ref.) | 1.00 | 1.00 |
| 2–4 | 4.73 (3.92–5.70) | 3.25 (2.67–3.97) |
| > 4 | 5.98 (4.98–7.18) | 4.01 (3.30–4.87) |
| Nephrologist, ≥ 1 visit | 0.86 (0.77–0.95) | 0.60 (0.53–0.67) |
| Cardiologist, ≥ 1 visit | 1.41 (1.30–1.52) | 1.25 (1.14–1.37) |
| Internist, ≥ 1 visit | 1.92 (1.81–2.03) | 1.63 (1.52–1.74) |
| Endocrinologist, ≥ 1 visit | 4.76 (4.17–5.45) | 2.64 (2.27–3.08) |
| Hospital admission, ≥ 1 admission | 0.72 (0.66–0.78) | 0.64 (0.58–0.71) |
Note: CI = confidence interval, HbA1c = hemoglobin A1c, OR = odds ratio, Ref. = reference group or level, SGLT2 = sodium–glucose cotransporter 2.
↵* Logistic regression including 62 823 of 76 630 adults with diabetes and chronic kidney disease eligible for SGLT2 inhibitor treatment (definition [B] in Table 1).
↵† Adjusted ORs from a multivariable logistic regression model adjusting for every other variable seen in this table. In crude analysis, all p < 0.001 except age 45–54 years (v. 55–64 yr, p = 0.004); rural residence (p = 0.1), neighbourhood income quintiles 2, 3 and 4 (v. quintile 5, p = 0.5, p > 0.9 and p = 0.4, respectively); HbA1c level > 9.0% (v. > 7.0 and ≤ 9.0%, p = 0.006); and ≥ 1 nephrology visit (p = 0.005). In multivariable analysis, all p < 0.001 except rural residence (p = 0.046); age 45–54 years (v. 55–64 yr, p = 0.2); neighbourhood income quintiles 2, 3 and 4 (v. quintile 5, p = 0.2, p = 0.2 and p = 0.6, respectively); stroke (p = 0.03); and HbA1c level > 9.0% (v. > 7.0 and ≤ 9.0%, p = 0.04).