A structured decision support system (DSS) may improve uptake of guideline-recommended therapies in type 2 diabetes mellitus (T2DM) with cardiorenal disease, according to findings published in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. The pilot study showed increased prescribing of sodium–glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), along with high medication adherence over 6 months.

This 6-month pilot study was conducted between December 2023 and September 2024, with study visits at baseline and 6 months. It included male and female Veterans aged 18 to 75 years with T2D, at least 1 cardiovascular event and or chronic kidney disease (CKD), and no baseline use of SGLT2i or GLP-1RA. Veterans with contraindications to SGLT2i or GLP-1RA and those with a serious mental health disorder were excluded. The primary outcome was initiation of SGLT2i or GLP-1RA compared with baseline. Secondary outcomes were weight, blood pressure, hemoglobin A1c (HbA1c), glomerular filtration rate (GFR), and medication adherence.

Following DSS use, all 14 Veterans were prescribed at least 1 therapy. SGLT2i were used in 12 patients and GLP-1RA in 2 patients. At 6 months, 13 of 14 Veterans remained on treatment. Weight decreased from 216 ± 41 lb to 213 ± 39 lb, blood pressure from 141/76 ± 20/10 to 132/73 ± 17/10 mmHg, and HbA1c from 7.7% ± 1.5% to 7.4% ± 0.8%. GFR remained unchanged at 64 mL/min. All continuing patients maintained adherence, with a medication possession ratio of at least 80%.

These findings indicate that DSS implementation was associated with higher prescribing of SGLT2i and GLP-1RA and sustained adherence in this setting. The results also suggest a role in supporting guideline-concordant care. Whether this approach translates into improved cardiorenal outcomes requires confirmation in larger studies.