Prescribing Practices and Clinical Support for GLP-1 Receptor Agonists in Youth-Onset Type 2 Diabetes: Data from the T1DX QI Collaborative
Author Block: YASHODA NAIK, RACHEL J. FENSKE, DHRUVI VORA, MONICA BIANCO, TAMARA S. HANNON, CINTYA SCHWEISBERGER, SIHAM ACCACHA, MILI V. VAKHARIA, ORI ODUGBESAN, ELIZABETH A. MANN, Middleton, WI, Boston, MA, Chicago, IL, Indianapolis, IN, Kansas City, MO, New Hyde Park, NY, Richmond, TX, Madison, WI
Introduction and Objective: The ADA recommends GLP-1 RAs in youth onset type 2 diabetes (YO-T2D) when glycemic targets are not met with metformin. We aimed to assess access to and usage of GLP-1 RAs in YO-T2D across pediatric diabetes centers within the T1D Exchange QI Collaborative (T1DX-QI).
Methods: The 2025 T1DX-QI annual survey was administered to all member centers. Responses were collected from representatives at each center. Descriptive analyses summarized GLP-1 RA use, insurance coverage, access, and monitoring.
Results: Among 42 responding pediatric centers 88% reported GLP-1 RA coverage for YO-T2D for privately insured and 81% for publicly insured patients. Estimated GLP-1 RA use varied widely with 25 centers reporting that ≤50% of patients with YO-T2D were prescribed GLP-1 RAs. Only 31% of centers reported having structured follow-up protocols with most centers relying on patients to schedule clinic visits instead of proactive outreach between appointments.
Conclusion: Reports of insurance coverage for GLP-1 RAs in YO-T2D were variable based on insurance type and prescribing rates were low for several centers, suggesting opportunities to support prescribers and patients in accessing GLP-1 RAs.
