The SGLT2i Treatment Gap in UK Primary Care: A Cross-Sectional RWE Study of Prescribing in Clinical Practice
In brief
Only 4% of eligible CKD patients receive SGLT2 inhibitors in UK primary care
In a cross-sectional analysis of 9.8 million adults, just 17.5% of all patients meeting NICE criteria for SGLT2 inhibitor therapy were prescribed the drugs, with the lowest uptake among chronic kidney disease-only patients (3.8%). Women and older adults were also less likely to be treated, highlighting a major gap in guideline implementation that could limit cardio-renal benefits.
- Journal
- Diabetes, obesity & metabolism (Q1)
- Published
- 10 September 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Chelsea Stefanska, Ryan Chung, Salman Ramjaun, Danyao Jin, Ciara Doherty, Kieran McCafferty, et al.
- PMID
- 42723263
- DOI
- 10.1111/dom.71298
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 16 September 2026): SGLT2i treatment gap in UK primary care
Abstract
AIMS: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) improve cardiovascular and renal outcomes in type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD) and chronic heart failure (CHF). Despite clinical guideline recommendations, SGLT2i uptake in UK primary care remains suboptimal and information on utilisation is limited. This study aims to quantify and describe the UK primary care population with T2DM, CKD and/or CHF who are eligible for but not currently prescribed an SGLT2i. MATERIALS AND METHODS: A cross-sectional study was conducted using routinely collected electronic health records from the Optimum Patient Care Research Database. Adults aged ≥ 18 years on 1 July 2024 were included. Descriptive analyses estimated disease prevalence (defined by morbidity-coded diagnosis), SGLT2i eligibility (defined using NICE clinical guidelines) and current SGLT2i treatment (defined as any SGLT2i prescription in the previous 2 months) by conditions and selected characteristics. Main results are based on diagnosed disease; in a separate CKD sensitivity analysis, indicative CKD (without a morbidity code) was defined using kidney function test results. RESULTS: In the study population of 9.8 million adults, prevalence was 6.52% for T2DM, 4.95% for diagnosed CKD (6.07% including indicative CKD) and 1.40% for CHF. Among all SGLT2i-eligible individuals, 17.5% were currently prescribed an SGLT2i. Current SGLT2i treatment was lowest in CKD-only patients (3.8% treated among eligible) and highest in those meeting eligibility criteria for all three indications (32.9% treated). SGLT2i treatment was lower in women and older adults. CONCLUSIONS: SGLT2i therapy is significantly underutilised in UK primary care, particularly for CKD. Equitable implementation of SGLT2i clinical guidelines is vital to improve cardio-renal-metabolic care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.