SGLT2i and GLP-1 RA therapy in type 1 diabetes and reno-vascular outcomes: a real-world study
Authors' conclusion
Both SGLT2is and GLP-1 RAs have potential benefits as adjunctive agents in type 1 diabetes. SGLT2is provide cardio-renal benefits, despite an increase in the risk of DKA and urinary tract infection compared with GLP-1 RA therapy. Long-term evaluation of the efficacy and safety of these adjunctive therapies is required to guide their use in individuals with type 1 diabetes.
Study context
- Population
- Patients aged 18 or over with T1D on the TriNetX platform196,691 with T1D identified
- Participants
- 992 vs 1,822
- Exposure
- Adjunctive SGLT2i vs GLP-1 RA therapy in T1D
- SGLT2in = 992
- GLP-1 RAn = 1,822reference
- Outcome
- HbA1c change
Methodological detailsreal-world, TriNetX global collaborative network
- Real-world
- TriNetX global collaborative network
Main finding
As reported in the abstract
SGLT2i
−2.6
mmol/mol [−0.2%]
GLP-1 RA
−5.4
mmol/mol [−0.5%]
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| HF | 0.44 (0.23–0.83) | P = 0.0092 | |
| CKD | 0.49 (0.28–0.86) | P = 0.0118 | |
| All-cause hospitalisation | 0.59 (0.46–0.76) | P ≤ 0.0001 | |
| 0.20.5125Relative risk (log scale) |
ml/min per 1.73 m²
| Outcome | SGLT2i | GLP-1 RA |
|---|---|---|
| eGFR change · 5 years | +3.5 | −7.2 |
eGFR change · 5 years
- Preservation of eGFR with SGLT2i, including patients with established chronic kidney disease (CKD)
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| DKA | 2.08 (1.05–4.12) | P = 0.0309 | |
| Urinary tract infection/pyelonephritis | 2.27 (1.12–4.55) | P = 0.019 | |
| 0.20.5125Relative risk (log scale) |
Original publication
SGLT2i and GLP-1 RA therapy in type 1 diabetes and reno-vascular outcomes: a real-world study. Diabetologia. Published 28 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →