A research in Diabetes Research and Clinical Practice demonstrated that the addition of sodium-glucose cotransporter-2 (SGLT2) inhibitors in type 2 diabetes patients on insulin lowers the risk of major microvascular complications, cardiovascular events, and mortality compared to dipeptidyl peptidase-4 (DPP-4) inhibitors. It also lowers the risk of major microvascular complications compared to glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
The study aimed to compare the risk of major microvascular complications and cardiovascular events of SGLT2 inhibitors compared to GLP-1 RAs and DPP-4 added to insulin therapy in T2D patients.
Researchers identified 20,655 propensity score–matched pairs of SGLT2 inhibitor and DPP-4 inhibitor users, and 10,445 matched pairs of SGLT2 inhibitor and GLP-1 RA users using Taiwan’s National Health Insurance Research Database (2008–2021). All the patients were receiving concurrent insulin therapy. The outcome risk was assessed using Cox proportional hazards models.
• Addition of SGLT2 inhibitors to insulin therapy in type 2 diabetes patients is linked with a lower risk of cardiovascular events compared to DPP-4 inhibitors.
• SGLT2 inhibitors significantly lower the risk of major microvascular complications compared to both DPP-4 inhibitors and GLP-1 receptor agonists.
• Patients on insulin and prescribed SGLT2 inhibitors had a lower all-mortaliy risk than those administered DPP-4 inhibitors.
Yen FS, Wei JCC, Huang Y, et al. Comparative outcomes of adding SGLT2 inhibitors versus incretin-based therapies to insulin in type 2 diabetes. Diabetes Res Clin Pract. Published online June 16, 2025:112328. doi:10.1016/J.DIABRES.2025.112328
Addition of sodium-glucose cotransporter-2 (SGLT2) inhibitors in type 2 diabetes patients on insulin lowers the risk of major microvascular complications, cardiovascular events, and mortality compared to dipeptidyl peptidase-4 (DPP-4) inhibitors.