Comparative outcomes of adding SGLT2 inhibitors versus incretin-based therapies to insulin in type 2 diabetes
Authors' conclusion
In patients with T2D on insulin, adding SGLT2 inhibitors was associated with lower risks of cardiovascular events, major microvascular complications, and mortality compared to DPP-4 inhibitors, and lower risk of major microvascular complications compared to GLP-1 RAs.
Study context
- Population
- Patients with T2D receiving concurrent insulin therapy, Taiwan's National Health Insurance Research Database (2008–2021)20,655 and 10,445 matched pairs
- Exposure
- SGLT2i vs DPP-4i or GLP-1 RA added to insulin
- Outcome
- Cardiovascular events and major microvascular complications
Methodological detailspropensity-score matched, Cox proportional hazards models
- Propensity-score matched
- Cox proportional hazards models
Main finding
As reported in the abstract
Major microvascular complications
Adjusted hazard ratio (95% CI)
SGLT2ivs DPP-4i
0.37(0.33–0.41)
SGLT2ivs GLP-1 RA
0.57(0.49–0.66)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| MACESGLT2ivs DPP-4i | 0.57 (0.53–0.61) | |
| All-cause mortalitySGLT2ivs DPP-4i | 0.42 (0.39–0.45) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Original publication
Comparative outcomes of adding SGLT2 inhibitors versus incretin-based therapies to insulin in type 2 diabetes. Diabetes Res Clin Pract. Published 16 June 2025. doi:10.
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