BMJ (Clinical research ed.)

Risk of high potassium levels with SGLT-2 inhibitors, GLP-1 receptor agonists, and DPP-4 inhibitors in people with type 2 diabetes

Updated

Abstract

Starting SGLT-2 inhibitor treatment is associated with a lower rate of hyperkalemia than DPP-4 inhibitor treatment.

  • The hazard ratio for hyperkalemia when using SGLT-2 inhibitors compared to DPP-4 inhibitors is 0.75.
  • SGLT-2 inhibitors also show a slight reduction in hyperkalemia rates compared to GLP-1 receptor agonists, with a hazard ratio of 0.92.
  • GLP-1 receptor agonists are associated with a lower rate of hyperkalemia than DPP-4 inhibitors, with a hazard ratio of 0.79.
  • The three-year absolute risk of hyperkalemia is 2.4% lower for SGLT-2 inhibitors compared to DPP-4 inhibitors.
  • Findings are consistent across various subgroups, including those with heart failure or chronic kidney disease.

Simplified

Full Text

Full text is available at the source.

Funding

Competing interests

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare the following: support from Brigham and Women’s Hospital, Harvard Medical School, the Netherlands Organization for Scientific Research, Patient-Centered Outcomes Research Institute, Food and Drug Administration, National Institutes of Health, National Institute on Aging, American Diabetes Association for the submitted work. EP is principal investigator of an investigator initiated grant to the Brigham and Women’s Hospital from Boehringer Ingelheim, not directly related to the topic of the submitted work; DJW reports serving on data monitoring committees for Novo Nordisk not related to the topic of this work; SJC reports serving on advisory boards for Alexion Pharmaceuticals and employment of a family member by a Johnson and Johnson company. No other potential conflicts of interest relevant to this article were reported.
PubMed

What Lands in Your Inbox Each Week:

  • 📚7 fresh studies
  • 📝plain-language summaries
  • direct links to original studies
  • 🏅top journal indicators
  • 📅weekly delivery
  • 🧘‍♂️always free