Healthcare disparities in heart failure patients (with and without type 2 diabetes) and use of sodium glucose co-transport inhibitors (SGLT2-i)

Excerpt

Co-existence of diabetes and heart failure (HF) complicates patient-care including medication adherence, diet/lifestyle changes, care-coordination across specialties, and increased out-of-pocket costs, contributing to worse outcomes. Further, these challenges are aggravated by socioeconomic disparities that disproportionately affect patients of color [1‐3]. Although recent trials of sodium-glucose-cotransporter-2 inhibitors (SGLT2-i) strengthened the rationale for co-management of diabetes and HF, only ~5% of patients in these trials were Black and the proportion belonging to Hispanic ethnicity was unclear [4]. The Bronx county in New York City (NYC) has some of the poorest neighborhoods in U.S. where ~30% of population is below poverty-line and overall death-rates in these neighborhoods are ~30% higher compared to other NYC neigbhourhoods [3]. Hence, as part of the Bronx-Heart initiative to understand and address the unique challenges faced by socioeconomically disadvantaged HF-patient population in the Bronx, we sought to phenotype the burden of diabetes, and understand any disparities including the use of SGLT2-i. …