Time to Treatment Intensification with Glucagon-Like Peptide-1 Receptor Agonists Versus Comparators in People with Type 2 Diabetes Treated with Metformin

May 22, 2025Diabetes therapy : research, treatment and education of diabetes and related disorders

Time until stronger treatment is needed with GLP-1 drugs versus other medicines in people with type 2 diabetes on metformin

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Abstract

A total of 59,958 participants were included, with GLP-1 receptor agonists (GLP-1RAs) linked to a lower rate of treatment intensification than other glucose-lowering medications.

  • Initiation of GLP-1RA treatment was associated with a reduced need for a subsequent glucose-lowering medication compared to SGLT2 inhibitors, DPP-4 inhibitors, and sulfonylureas.
  • The hazard ratios for treatment intensification were 0.93 for SGLT2is, 0.77 for DPP-4is, and 0.84 for SUs, all indicating a statistically significant difference.
  • After 12 months, patients on GLP-1RAs experienced a significantly greater reduction in glycated hemoglobin levels compared to those on SGLT2is, DPP-4is, and SUs.
  • GLP-1RA treatment also led to significantly greater reductions in body mass index after 12 months compared to DPP-4is and SUs, though not compared to SGLT2is.

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Key numbers

0.77
Lower Rate of
Hazard ratio for with vs.
31.4%
Weight Loss ≥ 5%
Percentage of participants with ≥ 5% weight loss after 12 months
46.6%
Glycemic Control Improvement
Proportion of patients achieving HbA < 7% after 12 months

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