Initiation of SGLT2 Inhibitors Versus DPP‐4 Inhibitors in Metformin Users and Risk of Incident Depression: A Nationwide, Claims‐Based Active‐Comparator New‐User Study
Main finding · Incident depressionResult — go to the resultHazard ratio 0.85 95% CI 0.73–0.99Authors' conclusion
Among 90-day adherent survivors with Type 2 diabetes receiving metformin, initiation of SGLT2 inhibitors as add-on therapy was associated with a lower risk of incident depression compared with DPP-4 inhibitors.
Study context
- Population
- Adults with newly diagnosed T2D receiving metformin, Korean National Health Insurance Service database (2014–2022)
- Participants
- 38,297 adults10,013 matched pairs
- Exposure
- SGLT2i vs DPP-4i initiation as add-on to metformin
- SGLT2 inhibitorsn = 10,013
- DPP-4 inhibitorsn = 10,013reference
- Outcome
- Incident depression (≥ 2 outpatient or inpatient claims with ICD-10 codes F32-F33)
Methodological detailsnationwide, active-comparator new-user, 90-day adherent-survivor landmark design, propensity score matched 1:1, claims-based
- Nationwide
- Active-comparator new-user
- 90-day adherent-survivor landmark design
- Propensity score matched 1:1
- Claims-based
Main finding
Incident depression
Hazard ratio
0.85
95% CI 0.73–0.99
Events by group
SGLT2 inhibitors
300
events
DPP-4 inhibitors
391
events
SGLT2 inhibitorsvs DPP-4 inhibitors
HR 0.85 (95% CI 0.73–0.99)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Incident depression in subgroups
- Associations generally consistent across clinically relevant subgroups; more pronounced in older adults, females and those with greater comorbidity burden
Suicide mortality
- Suicide mortality was infrequent in both groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Initiation of SGLT2 Inhibitors Versus DPP‐4 Inhibitors in Metformin Users and Risk of Incident Depression: A Nationwide, Claims‐Based Active‐Comparator New‐User Study. Diabetes Obes Metab. Published 1 September 2026. doi:10.
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