Rethinking the Access Gap: GLP-1 Injectable Use Among Hispanic Adults With Diabetes in the United States

Background

Glucagon-like peptide-1 (GLP-1)-based therapies have transformed diabetes and obesity management, but concerns remain about equitable access. Contemporary national data on GLP-1 utilization among Hispanic adults with diabetes are limited. We examined racial/ethnic patterns and clinical and socioeconomic correlates of injectable GLP-1 use among U.S. adults with diagnosed diabetes.

Methods

We conducted a cross-sectional secondary analysis of the 2024 National Health Interview Survey. Adults aged ≥18 years with diagnosed diabetes and a valid response regarding current non-insulin injectable medication use to lower blood glucose or body weight were included. Analyses included Hispanic, non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian adults. Survey weights, strata, and primary sampling units were incorporated. Weighted prevalence and 95% confidence intervals were calculated. Survey-weighted multivariable logistic regression adjusted for age, sex, body mass index, insurance, education, and family poverty ratio. A sensitivity analysis was restricted to type 2 diabetes.

Results

Among 3,573 adults with diagnosed diabetes, 566 were Hispanic. Weighted GLP-1 use was 31.3% (95% CI, 25.6–37.1) among Hispanic, 26.2% (24.0–28.3) among non-Hispanic White, 26.5% (21.3–31.8) among non-Hispanic Black, and 12.1% (6.7–17.5) among non-Hispanic Asian adults. In adjusted analysis (n=3,474), Hispanic adults had higher odds of GLP-1 use than non-Hispanic White adults (aOR 1.50; 95% CI, 1.10–2.04; p=.010). Obesity (aOR 2.25; 1.65–3.07; p<.001), some college/associate education (aOR 1.38; 1.08–1.75; p=.009), and bachelor’s degree or higher (aOR 1.38; 1.06–1.79; p=.018) were associated with greater use. Insurance and family poverty ratio were not independently associated. In the type 2 diabetes sensitivity analysis (n=2,914), the Hispanic-White association attenuated (aOR 1.37; 0.98–1.92; p=.066).

Discussion & Conclusion

Hispanic adults with diagnosed diabetes had relatively high GLP-1 utilization in 2024. The adjusted Hispanic-White difference weakened after restriction to type 2 diabetes, suggesting a more nuanced pattern than a simple access-gap framework. Clinical indication and education may contribute to utilization, while insurance and family poverty ratio alone did not explain observed differences. Future studies should examine affordability, prescribing, and treatment persistence.