Pharmacological treatment patterns, factors associated with glycemic control, and renal function parameters in a real-world cohort of Hispanic adults with type 2 diabetes.

Type 2 diabetes mellitus (T2DM) disproportionately affects Hispanic populations, yet real-world treatment patterns and factors associated with glycemic control in this group are poorly characterized. Optimal glycemic control is essential to reduce complications. A cross-sectional study of 1,397 Hispanic adults with T2DM was conducted in a community primary care clinic. Demographic characteristics, comorbidities, pharmacological regimens, glycemic control (HbA1c) and renal function parameters [estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio] were extracted from electronic medical records. Multivariable logistic regression was performed to identify factors independently associated with optimal glycemic control [glycated hemoglobin (HbA1c) ≤7%]. Overall, 59.6% of patients received glucose-lowering medications, with metformin being the most frequently prescribed agent. Monotherapy with sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists, or metformin was associated with the highest rates of glycemic control (≥85% achieving HbA1c ≤7%). Insulin and sulfonylurea use were associated with poorer glycemic and renal profiles, likely reflecting confounding by indication, as these agents were preferentially prescribed to patients with more advanced disease. The association between SGLT2 inhibitor use and lower eGFR similarly appeared to reflect targeted prescribing in patients with renal impairment. In multivariable analysis, female sex [adjusted odds ratio (aOR), 3.25] and frequent specialist visits (aOR 8.27) were independently associated with optimal glycemic control, whereas insulin and sulfonylurea use were independently associated with lower odds of achieving HbA1c ≤7%. In the current real-world Hispanic cohort, pharmacological patterns were strongly influenced by clinical complexity. These findings provide insight into diabetes management and factors associated with glycemic control in an underserved population receiving care in a community-based setting.