Swedish Primary Care Study Reveals Low Uptake of Heart-Protective Diabetes Drugs | Research

The takeaway

Despite guideline recommendations, SGLT2 inhibitor and GLP-1 RA use remains low among Swedish primary care patients with both heart disease and type 2 diabetes.

14,414 patients studied
Guideline-recommended cardioprotective diabetes drugs significantly underused in Swedish primary care

What the researchers found

SGLT2i and GLP-1 RA prescribing rates are substantially below guideline recommendations in Swedish primary care patients with IHD and T2D.

Why it matters

Even in a well-organized healthcare system like Sweden's, guideline-recommended therapies are underused, highlighting a global implementation gap.

How the study worked

Cross-sectional analysis of QregPV regional primary care quality registry data (September 2023); 209 healthcare centers; 14,414 patients.

What this study cannot tell us

Cross-sectional design captures a single time point; registry data may not capture all contraindications or clinical rationale for non-prescribing.

How to read the evidence

Cross-sectional registry analysis — provides prescribing prevalence data but cannot explain reasons for underuse.

When this study was published

Published 2026 in BMJ Open. Data from September 2023.

The bigger picture

The gap between what clinical trials prove effective and what patients actually receive is one of medicine's most persistent challenges, extending even to well-resourced healthcare systems.

Questions still open

What are the main barriers to SGLT2i/GLP-1 RA prescribing in Swedish primary care?
Would specialist-led initiatives or decision support tools improve prescribing rates?

Common questions

Are diabetes patients getting the best heart medications?

This study found many patients with both diabetes and heart disease in Sweden are not receiving SGLT2 inhibitors or GLP-1 drugs despite strong evidence these medications protect the heart.

Why are recommended drugs not being prescribed?

Barriers may include unfamiliarity with newer medications, concerns about side effects, cost, and the complexity of managing multiple conditions in busy primary care settings.

Read the original research

Use of SGLT2 inhibitors and GLP-1 receptor agonists in patients with ischaemic heart disease and type 2 diabetes in Swedish primary care: a cross-sectional analysis of regional primary care registry data (QregPV).

BMJ open, 16(2), e110395

View on PubMed ↗Publisher’s paper ↗

Citation

Andersson, Tobias; Bager, Johan-Emil; Hellgren, Margareta; Åberg, Maria; Mourtzinis, Georgios. (2026). Use of SGLT2 inhibitors and GLP-1 receptor agonists in patients with ischaemic heart disease and type 2 diabetes in Swedish primary care: a cross-sectional analysis of regional primary care registry data (QregPV).. BMJ open, 16(2), e110395. https://doi.org/10.1136/bmjopen-2025-110395