Effectiveness of GLP ‐1 RAs and SGLT ‐2is for Weight Loss and Glycaemic Control: An Observational Emulation of a Target Trial
Authors' conclusion
We estimated that, compared with SGLT-2is, liraglutide and dulaglutide provided superior glycaemic control and similar weight reduction over 5 years, and that semaglutide produced greater short-term reductions in both outcomes. Our analyses benchmark the results of short-term randomized trials and extend the evidence to longer periods.
Study context
- Population
- Individuals with Type 2 diabetes and obesity initiating GLP-1 RAs or SGLT-2is, Clalit medical records
- Exposure
- Three GLP-1 RAs vs SGLT-2is
- LIRAGLUTIDEn = 4,296
- DULAGLUTIDEn = 11,159
- SEMAGLUTIDEn = 5,041
- Outcome
- Absolute changes in body weight and HbA1c
- Follow-up
- During (up to 5 years for liraglutide/dulaglutide and 3 years for semaglutide)
Methodological detailsseparate target trials emulated, inverse-probability weighting to adjust for potential confounders, observational data from Clalit's medical records
- Separate target trials emulated
- Inverse-probability weighting to adjust for potential confounders
- Observational data from Clalit's medical records
Main finding
As reported in the abstract
Difference in weight loss, kg (95% CI)
SEMAGLUTIDEvs SGLT-2isat 18 months; greater weight loss with semaglutide
2.6(1.2–4.0)
- LIRAGLUTIDE vs SGLT-2is · at 18 months; greater HbA1c reduction with liraglutide
- difference in HbA1c reduction 0.4 % (95% CI 0.3–0.5)
- DULAGLUTIDE vs SGLT-2is · at 18 months; greater HbA1c reduction with dulaglutide
- difference in HbA1c reduction 0.7 % (95% CI 0.6–0.8)
- SEMAGLUTIDE vs SGLT-2is · at 18 months; greater HbA1c reduction with semaglutide
- difference in HbA1c reduction 0.6 % (95% CI 0.5–0.8)
- Long-term weight loss similar for liraglutide and dulaglutide compared with SGLT-2is at 5 years
- 6.4-7.3 kg
Observational data: associations, not effects.
Original publication
Effectiveness of GLP ‐1 RAs and SGLT ‐2is for Weight Loss and Glycaemic Control: An Observational Emulation of a Target Trial. Diabetes Obes Metab. Published 9 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →