Comparative Risk of Adverse Pancreatic Events With GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas Among Adults With Type 2 Diabetes at Moderate Cardiovascular Disease Risk
Authors' conclusion
GLP-1RA and DPP-4i therapy was not associated with increased risk of adverse pancreatic events. The lower risk of acute pancreatitis with SGLT2i therapy warrants further exploration.
Study context
- Population
- Adults with T2D and moderate cardiovascular risk starting GLP-1 RA, DPP-4i, SGLT2i or SUweighted cohort
- Participants
- 388,262 adults
- Exposure
- GLP-1 RA vs DPP-4i vs SGLT2i vs SU
- GLP-1RAn = 44,084
- DPP-4in = 82,079
- SGLT2in = 56,463
- Sulfonylurean = 205,636
- Outcome
- Incident acute pancreatitis and pancreatic cancer
Methodological detailsclaims data (OptumLabs Data Warehouse and fee-for-service Medicare), propensity scores (SuperLearner ensemble), inverse probability of treatment weighting
- Claims data (OptumLabs Data Warehouse and fee-for-service Medicare)
- Propensity scores (SuperLearner ensemble)
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
Acute pancreatitis
Hazard ratio (95% CI)
SGLT2ivs DPP-4i
0.82(0.68–0.98)
Sulfonylureavs GLP-1RA
1.28(1.03–1.56)
Sulfonylureavs SGLT2i
1.32(1.12–1.57)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Pancreatic cancerGLP-1RAvs DPP-4i | 0.56 (0.40–0.77) | |
| Pancreatic cancerSGLT2ivs GLP-1RA | 1.67 (1.12–2.49) | |
| Pancreatic cancerSulfonylureavs GLP-1RA | 1.60 (1.17–2.19) | |
| 0.512Hazard ratio (log scale) |
Original publication
Comparative Risk of Adverse Pancreatic Events With GLP-1 Receptor Agonists, SGLT2 Inhibitors, DPP4 Inhibitors, and Sulfonylureas Among Adults With Type 2 Diabetes at Moderate Cardiovascular Disease Risk. Endocr Pract. Published 11 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →