SGLT2 inhibitors are now prescribed more often to the patients they were meant for

If you have type 2 diabetes and also heart or kidney disease, there is a group of medicines made with you in mind. They are called SGLT2 inhibitors, and a new Medicare study shows that diabetes specialists are prescribing them more often to people like you.

The change started after the American Diabetes Association updated its guideline in 2019. The guideline pointed to these medicines for people with type 2 diabetes who also have heart disease, heart failure or chronic kidney disease. Doctors followed it, and the study measured by how much.

What are these medicines?

SGLT2 inhibitors and GLP-1 receptor agonists are two families of diabetes medicines. Both lower blood sugar. Both have also been shown to reduce heart and kidney problems in people with type 2 diabetes who already have heart disease, heart failure or chronic kidney disease.

Even so, these medicines were not being prescribed as often as they could be to the patients who stand to gain the most. The study asked whether the 2019 guideline changed that.

How the study worked

Researchers looked at traditional Medicare claims from 2017 to 2022. They followed people with type 2 diabetes who were treated by 1,061 endocrinologists, the doctors who specialize in diabetes and hormones. They compared how often prescriptions were filled for patients the guideline targeted with how often they were filled for other patients, using 2018 as the starting point. The results were published Oct. 1, 2026, in JAMA Network Open. The study looked at patterns over time, so it cannot prove the guideline was the cause, and it covers only endocrinologists and people on traditional Medicare.

What they found

For SGLT2 inhibitors, the gap grew a lot. From 2018 to 2022, fills rose about 11 percentage points more for targeted patients than for the others. The exact figure was 11.4 percentage points. The rise grew steadily year after year.

For GLP-1 drugs, fills also rose, but by less: 2.4 percentage points.

The researchers also compared doctors by their scores on a board knowledge assessment taken later, in 2022 to 2023. Among endocrinologists in the top quarter of scores, the SGLT2 inhibitor increase was 3.9 percentage points larger than among those in the bottom quarter. In other words, doctors who scored higher tended to put the new advice into practice faster. For GLP-1 drugs, the study did not find a clear difference by score.

What does this mean for you?

The news here is about how medicine works, and it is steady and reassuring. When experts review the evidence and update a guideline, prescribing at the specialist level does shift. For people with type 2 diabetes and heart or kidney disease, that means the medicines meant for them are reaching more of them.

The study did not test whether any one person should take one of these medicines. That depends on your health, your other medications and your history. What it does tell you is that these medicines are now a standard part of the conversation for people in your situation.

What you can do today

If you have type 2 diabetes plus heart disease, heart failure or kidney disease, write one question on a sticky note or in your phone: “Would an SGLT2 inhibitor or a GLP-1 drug make sense for me, and if not, why not?” Bring it to your next visit. If you are on Medicare, you can also look up your Part D plan’s drug list at Medicare.gov to see how these medicines are covered, so you go in knowing your options.