Glucagon‐like peptide‐1 receptor agonist versus sodium‐glucose cotransporter‐2 inhibitor persistence in Medicare Advantage beneficiaries with type 2 diabetes, cardiovascular risk, and obesity
Authors' conclusion
At 1 year, SGLT2i users showed higher persistence and augmentation than GLP-1 RA users. This may reflect better tolerance, fewer side effects, improved glucose control, preferences for oral medications, lower patient costs, and easier access to SGLT2i medications. Providers may support improved persistence by addressing patient-specific factors influencing therapy choices.
Study context
- Population
- Adults with T2D newly initiating GLP-1 RA or SGLT2i, 1 January 2018–30 June 2022, Humana Medicare Advantage claims; mean age 68.2 years, 52.2% femalematched cohort
- Participants
- 22,167 vs 22,267
- Exposure
- GLP-1 RA vs SGLT2i initiation
- GLP-1 RAn = 22,167
- SGLT2in = 22,267reference
- Outcome
- Treatment persistence (therapy gap <45 days)
- Follow-up
- 12 months post-index
Methodological detailsclaims data, 1:1 matched
- Claims data
- 1:1 matched
Main finding
As reported in the abstract
Persistence (gap <45 days) · 1 year
P < 0.001
Observational data: associations, not effects.
Further findings
Augmentation · 1 year
P < 0.001
Persistence, 30-day gap
Persistence, 90-day gap
| Outcome | HR | P value |
|---|---|---|
| Discontinuation | 1.39 | P < 0.001 |
CVD and obesity subgroups
- Cardiovascular and obesity subgroup findings were consistent with overall findings
Original publication
Glucagon‐like peptide‐1 receptor agonist versus sodium‐glucose cotransporter‐2 inhibitor persistence in Medicare Advantage beneficiaries with type 2 diabetes, cardiovascular risk, and obesity. Diabetes Obes Metab. Published 30 October 2025. doi:10.
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