Risk of morbidity and mortality in patients with type 2 diabetes treated with sodium-glucose cotransporter-2 inhibitor and/or dipeptidyl peptidase-4 inhibitor: a nationwide study

Jan 21, 2021BMJ open diabetes research & care

Health risks and death rates in people with type 2 diabetes using SGLT-2 and/or DPP-4 inhibitor treatments: a nationwide study

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

treatment is associated with a 20% lower risk of all-cause mortality compared to treatment.

Both SGLT2i and DPP-4i groups included 18,583 patients after matching.
SGLT2i treatment is linked to a lower risk of hospitalization for heart failure (HR, 0.81) compared to DPP-4i.
The risk of cancer is reduced by 25% (HR, 0.75) in patients treated with SGLT2i versus DPP-4i.
SGLT2i is associated with a higher risk of lower limb amputation (HR, 1.35) compared to DPP-4i.
Combining SGLT2i with DPP-4i results in a 54% reduction in all-cause mortality (HR, 0.46).

AI simplified

INTRODUCTION: Mortality and disability in diabetes mellitus are determined mostly by cardiovascular complications and cancer. The impact of dipeptidyl peptidase-4 inhibitor () and sodium-glucose cotransporter-2 inhibitor () monotherapy or combination on long-term complications of type 2 diabetes mellitus was studied.

RESEARCH DESIGN AND METHODS: Patients with type 2 diabetes treated with DPP-4i or SGLT2i during a 3-year period were identified in the database of the National Institute of Health Insurance Fund in Hungary. All-cause mortality, acute myocardial infarction, stroke, hospitalization for heart failure (HHF), lower limb amputation (LLA) and cancer were assessed. Outcomes of add-on SGLT2i to DPP-4i treatment in comparison with switching DPP-4i therapy to SGLT2i were also evaluated. After propensity score matching, survival analysis was performed with a Cox proportional hazards model.

RESULTS: After propensity score matching, both SGLT2i and DPP-4i groups included 18 583 patients. All-cause mortality (HR, 0.80; 95% CI 0.68 to 0.94; p=0.0057), HHF (HR, 0.81; 95% CI 0.71 to 0.92; p=0.0018), and risk of cancer (HR, 0.75; 95% CI 0.66 to 0.86; p<0.0001) were lower in the SGLT2i population compared with DPP-4i. Risk of LLA was higher in the SGLT2i group (HR, 1.35; 95% CI 1.03 to 1.77; p=0.0315). SGLT2i in combination with DPP-4i results in lower all-cause mortality (HR, 0.46; 95% CI 0.31 to 0.67; p=0.0001), with a lower trend in stroke, LLA, HHF and cancer, but without any statistical difference.

CONCLUSIONS: SGLT2i treatment leads to a lower risk of overall mortality, HHF and cancer when compared with DPP-4i treatment. Adding SGLT2i to DPP-4i instead of switching from DPP-4i to SGLT2i further lowers the risk of all-cause mortality.

Key numbers

20%

Decrease in All-Cause Mortality

Risk of all-cause mortality lower in group vs. group.

19%

Decrease in Hospitalization for Heart Failure

Risk of hospitalization for heart failure lower in group vs. group.

25%

Decrease in Cancer Risk

Risk of cancer lower in group vs. group.

Full Text

We can’t show the full text here under this license. Use the link below to read it at the source.

View full text ↗

Risk of morbidity and mortality in patients with type 2 diabetes treated with sodium-glucose cotransporter-2 inhibitor and/or dipeptidyl peptidase-4 inhibitor: a nationwide study

Abstract

Key numbers

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Key numbers

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief