A real-world study published in Diabetes, Obesity and Metabolism found that adults with T2DM were more likely to remain on SGLT2i therapy than on GLP-1 RAs.

Using Humana Healthcare Research claims data from January 2018 to June 2022, investigators compared 12-month treatment patterns among 22,167 GLP-1 RA and 22,267 SGLT2i initiators. Persistence, defined as continuous therapy without a >45-day gap, was higher for SGLT2i users (47% vs 37.6%). GLP-1 RA initiators were more likely to discontinue therapy (HR = 1.39, p < 0.001).

Treatment augmentation, defined as the initiation of a new glucose-lowering class, was also more common with SGLT2 inhibitors (27.4% vs 23.4%). Subgroup analyses in patients with cardiovascular disease and obesity showed similar patterns.

These findings suggest that the oral route, favorable tolerability, and lower cost may contribute to stronger adherence with SGLT2i therapy. Addressing patient-specific barriers could further enhance persistence and long-term glycemic outcomes.