Glycemic therapies and the risk of gastrointestinal adverse events in veterans with type 2 diabetes
Authors' conclusion
In patients with type 2 diabetes at risk for gastroparesis, SGLT2i might be the preferred agent. In patients for whom SGLT2i is not an option or another agent is needed, patients and providers might need to weigh the higher risk of death with insulin glargine against the higher risk of gastroparesis with GLP-1RA.
Study context
- Population
- Veterans with T2D initiating GLP-1 RA, SGLT2i or insulin glargine, 1 January 2018–31 December 2021
- Participants
- 141,080 veterans
- Exposure
- GLP-1 RA vs SGLT2i vs insulin glargine
- GLP-1RAn = 19,765
- SGLT2in = 75,058reference
- Insulin glarginen = 46,257
- Outcome
- GI adverse events: gastroparesis, intestinal obstruction, gallstones, acute cholecystitis, acute pancreatitis; and all-cause death
Methodological detailsactive comparator, new user design, inverse probability weighted Cox regression
- Active comparator
- New user design
- Inverse probability weighted Cox regression
Main finding
As reported in the abstract
Gastroparesis, intestinal obstruction and all-cause death
Hazard ratio (95% CI)
GLP-1RAvs SGLT2igastroparesis
1.65(1.33–2.05)
GLP-1RAvs Insulin glarginegastroparesis
1.24(1.02–1.52)
GLP-1RAvs Insulin glargineall-cause death
0.62(0.58–0.66)
Insulin glarginevs SGLT2igastroparesis
1.29(1.07–1.56)
Insulin glarginevs SGLT2iintestinal obstruction
1.26(1.11–1.43)
Insulin glarginevs SGLT2iall-cause death
1.58(1.50–1.65)
Observational data: associations, not effects.
Original publication
Glycemic therapies and the risk of gastrointestinal adverse events in veterans with type 2 diabetes. Diabetes Obes Metab. Published 30 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →