All‐cause mortality and cardiovascular outcomes with sodium‐glucose Co‐transporter 2 inhibitors, glucagon‐like peptide‐1 receptor agonists and with combination therapy in people with type 2 diabetes
Authors' conclusion
SGLT2i, GLP-1RAs or combination therapy confers mortality and cardiovascular protection in people with type 2 diabetes over 5 years. Combination therapy was associated with the greatest risk reduction in all-cause mortality versus a propensity matched control cohort. In addition, combination therapy offers a reduction in 5-year all-cause mortality when compared directly against either monotherapy.
Study context
- Population
- People with T2D receiving insulin across 85 health care organizations2.2 million source cohort
- Exposure
- SGLT2i, GLP-1RA or SGLT2i + GLP-1RA vs no SGLT2i/GLP-1RA
- SGLT2in = 143,600
- GLP-1RAn = 186,841
- SGLT-2i + GLP-1RAn = 108,504
- Outcome
- All-cause mortality, hospitalization and cardiovascular/macrovascular disease
- Follow-up
- 5 years
Methodological detailspropensity-score matched 1:1, global federated health research network, 85 health care organizations
- Propensity-score matched 1:1
- Global federated health research network
- 85 health care organizations
Main finding
As reported in the abstract
All-cause mortality
Each group vs controlHazard ratio (95% CI)
SGLT2i
0.49(0.48–0.50)
GLP-1RA
0.47(0.46–0.48)
SGLT-2i + GLP-1RA
0.25(0.24–0.26)
Observational data: associations, not effects.
Further findings
| Outcome | HR | |
|---|---|---|
| Hospitalization · 5 yearsSGLT2ivs Control | 0.73 (95% CI 0.72–0.74) | |
| Hospitalization · 5 yearsGLP-1RAvs Control | 0.69 (95% CI 0.68–0.69) | |
| Hospitalization · 5 yearsSGLT-2i + GLP-1RAvs Control | 0.60 (95% CI 0.59–0.61) | |
| Acute MI · 5 yearsSGLT2ivs Control | 0.75 (95% CI 0.72–0.78) | |
| Acute MI · 5 yearsGLP-1RAvs Control | 0.70 (95% CI 0.68–0.73) | |
| Acute MI · 5 yearsSGLT-2i + GLP-1RAvs Control | 0.63 (95% CI 0.60–0.66) | |
| All-cause mortality, combination vs monotherapy (sub-analysis) · 5 yearsSGLT-2i + GLP-1RAvs SGLT2i | 0.53 (CI 0.50–0.55) | |
| All-cause mortality, combination vs monotherapy (sub-analysis) · 5 yearsSGLT-2i + GLP-1RAvs GLP-1RA | 0.56 (CI 0.54–0.59) | |
| 0.512Hazard ratio (log scale) |
Other outcomes · 5 years
- All other outcomes showed a significant risk reduction in favour of the intervention cohorts
Original publication
All‐cause mortality and cardiovascular outcomes with sodium‐glucose Co‐transporter 2 inhibitors, glucagon‐like peptide‐1 receptor agonists and with combination therapy in people with type 2 diabetes. Diabetes Obes Metab. Published 29 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →