Takeaway
- In a comparison of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and long-acting glucagon-like peptide-1 receptor agonists (GLP-1RAs) in treating type 2 diabetes (T2D), each class shows greater benefit for specific outcomes.
Why this matters
- Few head-to-head data are available for T2D treatments.
Study design
- Systematic review/meta-analysis of 64 trials with 31,384 participants.
- Funding: National Institute for Health Research, UK.
Key results
- Steeper HbA1c reductions (95% credible interval; CrI) at 24 weeks with long-acting GLP-1RAs vs:
- SGLT2is: −0.28% (−0.47% to −0.10%); and
- Short-acting GLP-1RAs: −0.46% (−0.67% to −0.25%).
- Compared with other treatments vs placebo, the greatest HbA1c reduction was seen with long-acting GLP-1RA semaglutide at:
- 24 weeks: −1.49% (−1.76% to −1.22%); and
- 52 weeks: −1.38% (−2.05% to −0.71%).
- Steeper BP reductions at 24 weeks with SGLT2is vs short-acting GLP-1RAs:
- Systolic: −1.62 mmHg (−3.18 to −0.05).
- Diastolic: −1.32 mmHg (−2.05 to −0.65).
- Steeper cholesterol reductions with long-acting GLP-1RAs vs SGLT2is:
- Total: −0.24 mmol/L (−0.39 to −0.09).
- High-density lipoprotein: −0.08 mmol/L (−0.15 to −0.01).
- Low-density lipoprotein: −0.19 mmol/L (−0.31 to −0.07).
- Genital infection odds were higher with SGLT2is:
- OR, 5.26 (95% CrI: 1.45-25.00).
- Diarrhea odds (ORs) were higher with:
- Short-acting GLP-1RAs: 1.65 (95% CrI: 1.09-2.49); and
- Long-acting GLP-1RAs: 2.23 (95% CrI: 1.51-3.28).
Limitations
- GLP-1RA formulation differences not analyzed.
- Limited follow-up.
Only healthcare professionals with a Univadis account have access to this article.
You have reached your limit of complementary articles
Free Sign Up Available exclusively to healthcare professionals