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Study breakdown

GLP-1 and SGLT2 Drugs Equally Prescribed in HIV+ and HIV- Diabetic Patients, But Underused Overall

evidence
The takeaway

PLWH with T2D received similar SGLT2i/GLP-1 RA prescriptions as HIV-negative controls (30% vs 28.3%), but only one-third with established CVD received these evidence-based therapies.

Equal access, overall underuse

HIV+ patients receive GLP-1/SGLT2 drugs at the same rate as HIV- patients, but only one-third of high-risk patients in either group get these proven therapies

What the researchers found

No significant difference in SGLT2i/GLP-1 RA prescribing: PLWH 30.0% vs controls 28.3% (p=0.86). Only ~33% with established CVD received these drugs (p=0.63). PLWH had more self-care difficulties (p=0.038).

Why it matters

Ensuring PLWH have equal access to GLP-1 drugs is important, but the bigger problem is that most high-risk diabetic patients — HIV+ or not — are undertreated.

How the study worked

Retrospective and prospective data from urban German outpatient clinics comparing PLWH with T2D to HIV-negative controls for medication use, prescribing patterns, and quality of life.

What this study cannot tell us

Small sample. Single-country study. Cannot assess adherence or outcomes. Cross-sectional snapshot.

How to read the evidence

Small observational primary care study. Useful for equity assessment but limited generalizability.

When this study was published

Published in 2025.

The bigger picture

HIV status does not appear to limit access to modern diabetes drugs in Germany, but overall guideline-recommended prescribing remains low for all high-risk diabetic patients.

Questions still open

  • Why are only one-third of CVD+T2D patients receiving evidence-based drugs?
  • Do GLP-1 drugs interact with antiretroviral therapy?
  • Would targeted prescribing initiatives improve utilization?

Common questions

Can HIV patients take GLP-1 drugs?
Yes. This study found HIV-positive diabetic patients received GLP-1 and SGLT2 drugs at the same rate as HIV-negative patients with no apparent barriers to prescribing.
Why are so few high-risk patients getting these drugs?
Despite proven cardiovascular benefits, only about one-third of diabetic patients with heart disease receive GLP-1 or SGLT2 drugs. This represents a significant treatment gap that needs addressing.

Read the original research

SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany.

Primary care diabetes

Citation

Hilgefort, L; Potthoff, A; Nambiar, S; Schlottmann, R; Kaup, B; Ebigbo, A; Schmidt, W E; Nonseid-Jansen, H; Jansen, W A; Skaletz-Rorowski, A; Quast, D R. (2026). SGLT-2 inhibitors and GLP-1 receptor agonists in primary care pharmacotherapy of type 2 diabetes in people living with HIV versus HIV-negative controls: Findings from a multicenter study in Germany.. Primary care diabetes. https://doi.org/10.1016/j.pcd.2026.01.005