Background

In 2021, over 38 million people in the United States had diabetes mellitus, accounting for 1 of 4 healthcare dollars spent. Racial and ethnic minorities and those with limited English proficiency suffer from disparities in prevalence and control. Despite clinical guidelines indicating the use of sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), studies have demonstrated racial, ethnic, gender, and socioeconomic disparities in their use.

Methods

This is a qualitative study exploring the experiences of Spanish-speaking, Latinx patients with diabetes as they navigate pharmacologic diabetes treatment options within the context of shared decision making. Our study consists of up to 30 semi-structured interviews, conducted in person or virtually, with self-identified Latino/a adults with a diagnosis of diabetes and indication for the use of SGLT2i or GLP-1RA. Using a snowball sampling method, participants who have had at least two visits with a primary care provider in the last 12 months are being recruited from UCLA Family Health Center and LA County Mid-Valley Comprehensive Healthcare Center. Thematic analysis will be used to identify barriers and facilitators to decision-making and descriptive statistics will be calculated. Interviews are ongoing and currently four have been completed.

Results

We postulate that emerging themes from the interviews will include language concordance, support network, affordability, body image, use of social media and trust or lack thereof in the healthcare system. We predict language discordance and subsequent mistrust in their provider, and cost will be major barriers, leading to decreased utilization of these medications. Opposingly, language concordance leading to increased trust in their provider, social media, a patient’s support network and weight loss will be facilitators.

Conclusion

Results from this research study have clinical implications, contributing to the literature examining disparities in GLP-1 RA and SGLT2i use and access.They will also inform future comparative studies and claims-based studies of medication use among Latinos with diabetes in California.