# A cross-sectional survey of knowledge regarding sodium-glucose co-transporter 2 inhibitors (SGLT2is) among primary care physicians and pharmacists in China

## TL;DR

This study assesses the knowledge of primary care physicians and pharmacists in China regarding SGLT2 inhibitors for diabetes management.

## Contribution

The study provides the first cross-sectional survey on SGLT2i knowledge among primary healthcare workers in China.

## Key findings

- Most participants scored 9–11 out of 16 on SGLT2i knowledge.
- Only 15.44% knew to discontinue SGLT2is before major surgery.
- Female participants scored significantly higher than males.

## Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) occupy a pivotal role in the management of Type 2 diabetes due to their unique glucose-lowering mechanism and multiple clinical benefits. Physicians, as decision-makers in treatment, and pharmacists, as disseminators of drug knowledge, play crucial roles in ensuring the effectiveness and safety of treatments involving SGLT2is. However, the extent of primary healthcare workers’ understanding of SGLT2i characteristics prior to usage remains unclear.

This study aims to evaluate the level of knowledge pertaining to the use of SGLT2is among primary care physicians and hospital pharmacists.

A field survey on the cognition of SGLT2is was conducted among internal medicine, surgical, general practice, and pharmacy departments within healthcare institutions and community health service centers in Kaihua County, Zhejiang Province, China. An online questionnaire, including demographic information and knowledge about SGLT2is, was designed and administered.

The survey included 105 physicians and 31 pharmacists, with 59.56% being male and 66.18% holding intermediate or senior professional titles. Scores were predominantly in the range of 9–11 out of a maximum of 16 points, encompassing 102 participants (75.00%), while 9 individuals (11.76%) scored 13 points or higher, and 13 participants (9.56%) scored 8 points or lower. Notably, 33.09% correctly identified that SGLT2is are not applicable for Type 1 diabetes patients, 15.44% correctly noted the need to discontinue SGLT2is before major surgery, 23.53% correctly answered that SGLT2is are not approved in China for treating Type 2 diabetes in children and adolescents, and 47.06% correctly recognized that SGLT2is can be combined with metformin to enhance glucose-lowering effects. Additionally, the average score of physicians in surgical departments was significantly lower than other departments (H = 19.733, P < 0.001), and female participants had significantly higher average scores than males (Z = -3.528, P < 0.001).

Primary care physicians and pharmacists in Kaihua County exhibit a robust understanding of the mechanisms of SGLT2is. However, there are notable deficiencies in the management of perioperative care in surgery, in discerning indications across internal and general medicine, in identifying contraindications in special populations, and in the pharmacists’ roles in prescription review. These findings suggest a need for targeted educational initiatives to enhance understanding and safe use of SGLT2 inhibitors at the primary-care level.