Comprehensive drug safety assessment of sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and dipeptidyl peptidase 4 inhibitors: A Danish population-based active comparator new user cohort study
Authors' conclusion
While some signals likely reflect residual confounding, several signals - particularly those related to infections and cancer - warrant further investigation.
Study context
- Population
- Initiators of newer glucose-lowering therapies, Danish nationwide registries
- Participants
- 49,365 / 33,018 / 50,531
- Exposure
- SGLT2i vs GLP-1 RA vs DPP-4i initiators
- SGLT2in = 49,365
- GLP1-RAn = 33,018
- DPP4in = 50,531
- Outcome
- Adverse events (active safety monitoring)
Methodological detailsnew user design, nationwide registries
- New user design
- Nationwide registries
Main finding
As reported in the abstract
Adverse event signals
Hazard ratio (95% CI)
SGLT2ivs GLP1-RAphimosis
1.69(1.42–2.02)
SGLT2ivs DPP4iphimosis
2.19(1.84–2.59)
SGLT2ivs GLP1-RAsecondary polycythaemia
2.67(1.62–4.38)
SGLT2ivs DPP4isecondary polycythaemia
1.63(1.14–2.32)
DPP4ivs SGLT2ibacterial intestinal infections
1.56(1.18–2.08)
DPP4ivs GLP1-RAbacterial intestinal infections
2.08(1.49–2.94)
DPP4ivs SGLT2ianaemia
2.00(1.22–3.23)
DPP4ivs GLP1-RAanaemia
1.92(1.18–3.23)
GLP1-RAvs SGLT2iuterine cancer (near-immediate elevated risk)
1.82(1.20–2.78)
GLP1-RAvs DPP4iuterine cancer (near-immediate elevated risk)
1.94(1.19–3.16)
- Associations identified
- 43
- Obesity-related signals disregarded
- 2
- Beneficial effects observed
- 7
Observational data: associations, not effects.
Original publication
Comprehensive drug safety assessment of sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and dipeptidyl peptidase 4 inhibitors: A Danish population-based active comparator new user cohort study. Diabetes Res Clin Pract. Published 26 May 2026. doi:10.
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