GLP-1 and SGLT2: a US review highlights persistent inequalities in access

What the researchers studied

The review brings together US studies published from 2013 to 2026 on the use of these two drug classes. It examines disparities in prescribing or treatment initiation across several social, demographic and healthcare access characteristics.

This is not a trial directly comparing the medications with a placebo. The central question is access to them. Only the PubMed abstract was consulted: total participant numbers, follow-up durations and detailed study quality assessments are not available in the source material.

Gaps that persist despite growing use

The most consistent disparities concern race or ethnicity, socioeconomic status, insurance coverage, age and access to specialists. Black and Hispanic patients, Medicaid beneficiaries, low-income populations and older adults frequently received fewer prescriptions or were less likely to start treatment.

Findings related to sex and geography are more heterogeneous. The abstract also reports increased use following major trials and guideline updates, but uptake remained well below the level expected for the eligible population. Some disparities persisted or widened for newer agents.

A proposed framework, not a proven solution

The authors propose an equity-focused framework: monitor access gaps, identify eligible patients, adapt care pathways, reduce structural barriers and support patients and clinicians. The abstract does not report an evaluation demonstrating that this framework actually reduces inequalities.

These findings concern the US healthcare system. They do not directly describe the situation in France, where coverage and access conditions differ. Above all, they highlight the need to distinguish two questions: how effective a medication is and whether the patients who could benefit can actually access it.

What we can take away

Increasing use of GLP-1 agonists and SGLT2 inhibitors is not enough to ensure equitable access. This review documents a US problem, without measuring the magnitude of the gaps in the abstract or demonstrating the effectiveness of the proposed solutions.