Combining GLP1 receptor agonists (GLP1-RA) with SGLT2 inhibitors (SGLT2i) provides enhanced kidney protection in adults with type 2 diabetes, according to UK data presented at the European Association for the Study of Diabetes Congress 2025.

The study analyzed electronic health records (2013–2023) of 40,112 patients on GLP1-RA, 122,343 on SGLT2i, 21,223 on combination therapy, and 143,392 on DPP4i or sulfonylureas. Kidney disease progression—≥50% decline in eGFR, end-stage kidney disease, or kidney-related death—was assessed over three years.

Incidence was lowest with combination therapy (2.8 per 1,000 patient-years) and highest with DPP4i/SU (5.5 per 1,000 patient-years). Combination therapy reduced progression risk by 55% versus DPP4i/SU and 21% versus SGLT2i alone. Effects appeared additive. Using the CKD Prognosis Consortium risk score to target high-risk patients improved absolute risk reduction compared with albuminuria-based targeting.

These findings support GLP1-RA + SGLT2i combination therapy and risk-based targeting to optimize kidney protection in type 2 diabetes.