Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Retinopathy in Patients With Type 2 Diabetes
Authors' conclusion
This cohort study found that SGLT2i was associated with a lower risk of sight-threatening retinopathy compared with DPP-4i, pioglitazone, and sulfonylureas. This finding suggests that SGLT2i may play a role not only in reduced risk of diabetic nephropathy but also in the slow progression of diabetic retinopathy in patients with T2D.
Study context
- Population
- Adults with newly diagnosed T2D (2009–2019), Taiwan National Health Insurance Research Database, followed up until December 31, 2020; matched patients 58.6% male, mean (SD) age 56.9 (11.8) yearsnewly diagnosed T2D identified
- Participants
- 3,544,383 adults
- Exposure
- SGLT2i vs DPP-4i, pioglitazone or SU
- Outcome
- Sight-threatening retinopathy
Methodological detailsnew-user design, active-comparator design, 1:1 propensity score matched, nationwide database (Taiwan NHIRD), Data analyzed between August 18, 2022, and May 5, 2023
- New-user design
- Active-comparator design
- 1:1 propensity score matched
- Nationwide database (Taiwan NHIRD)
- Data analyzed between August 18, 2022, and May 5, 2023
Main finding
As reported in the abstract
Adjusted hazard ratio (95% CI)
SGLT2ivs DPP-4i
0.57(0.51–0.63)
SGLT2ivs Pioglitazone
0.75(0.69–0.81)
SGLT2ivs Sulfonylureas
0.62(0.53–0.71)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Cumulative incidence of sight-threatening retinopathy (Kaplan-Meier)SGLT2i vs DPP-4i · 3.52 vs 6.13; lower with SGLT2i | P < 0.001 |
| Cumulative incidence of sight-threatening retinopathy (Kaplan-Meier)SGLT2i vs Pioglitazone · 4.32 vs 5.76; lower with SGLT2i | P < 0.001 |
| Cumulative incidence of sight-threatening retinopathy (Kaplan-Meier)SGLT2i vs Sulfonylureas · 2.94 vs 4.67; lower with SGLT2i | P < 0.001 |
Original publication
Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Retinopathy in Patients With Type 2 Diabetes. JAMA Netw Open. Published 1 December 2023. doi:10.
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