Using real-world big data to improve the use of new therapies for heart and kidney disease…

Doctor Beryl Lin, Baker Heart and Diabetes Institute

Postgraduate Scholarship

Years funded: 2026 - 2028

Using real-world data to improve new therapies for heart and kidney disease in people with type 2 diabetes

Heart disease is the leading cause of death in people living with diabetes, who face significantly higher risks of heart and kidney failure than the general population. In the last decade, new medications called SGLT2 inhibitors and GLP-1 receptor agonists have revolutionised diabetes care. Clinical trials show these therapies significantly reduce heart disease, protect kidney function, and save lives. However, translating the benefits seen in research into the real-world remains a major challenge. Studies from the US and UK show these medications are underused, especially in people at the highest risk. Our group has found that Australians living in disadvantaged areas are less likely to receive newer diabetes medications. Clinical trials also tend to underrepresent key groups like older adults and those from diverse ethnic backgrounds, yet they carry a disproportionately high burden of diabetes and cardiovascular disease. As disparities in care are widening, there is a critical need for real-world evidence to understand the true effectiveness and safety of these therapies across the whole diabetes population.

This PhD will use whole-of-population data from Australia and globally to generate urgently needed evidence on the real-world impact of these medications: how they are being used, who is missing out, and what must change to improve access and outcomes.

First, we will analyse data from over 1.5 million Australians with type 2 diabetes to examine trends in the use of SGLT2 inhibitors and GLP1 agonists over time, and whether it has reduced heart failure and deaths across the population. We have preliminary data to suggest that outcomes have not improved - posing the question: why not? We will then interrogate prescribing practices to identify potential inequities based on age, gender, ethnicity or socioeconomic status. We will also conduct focus groups with patients and clinicians to understand their experiences, and real-world barriers to adherence and access. Finally, through a global collaboration involving 24 countries with over 5 billion years of follow-up, we will analyse international trends in diabetes-related heart and kidney disease, and evaluate the real-world effectiveness and safety of these therapies across different populations and health systems.

This research will help bridge the gap between clinical trials and real-world impact. It will deliver evidence needed to inform equitable, population-wide implementation to help prevent heart and kidney disease for people living with diabetes. Findings will be shared through publications, conferences, and health promotion through policy-makers and organisations such as the Heart Foundation.