Implementation of SGLT2 Inhibitor Use and Clinical Outcomes in Outpatients with Type 2 Diabetes or Heart Failure at Duc Giang General Hospital

Abstract

Objectives: this study aimed to evaluate the implementation of SGLT2 inhibitor (SGLT2i) prescribing regulations and to describe clinical outcomes in outpatients with type 2 diabetes mellitus (T2DM) or heart failure (HF). Methods: A descriptive longitudinal study was conducted from February to September 2025. Patients who met the priority criteria for SGLT2i therapy and were prescribed these agents were included. Clinical, laboratory, and prescription data were collected at baseline and during follow-up. Medication adherence was assessed using medication possession ratio (MPR), with ≥80% considered acceptable adherence. Results: A total of 222 patients receiving SGLT2i were included (mean age 71.5 ± 10.0 years; 54.5% female). Among them, 64.4% had T2DM 35.6% had HF. The proportion of patients achieving MPR ≥ 80% was 77.9%. In the T2DM subgroup, HbA1c decreased by 1.06% after 3 months (p < 0.001). In the HF subgroup, ejection fraction (EF) improved from 35.3% to 48.7% (p < 0.001). Estimated glomerular filtration rate (eGFR) showed a modest initial decline but stabilized after 6 months. Most adverse drug reactions were mild to moderate. Conclusions: Implementation of prescribing regulations improved access to SGLT2i therapy in routine clinical practice. Observed improvements in glycemic control and cardiac function suggest potential benefits; however, these findings should be interpreted cautiously due to the observational design and concomitant therapies.