The risk of progressing to sight-threatening diabetic retinopathy appears lower with use of sodium-glucose cotransporter 2 (SGLT2) inhibitors than other second-line glucose-lowering medications, as per research conducted in Taiwan.
SGLT2 inhibitors, which are also called gliflozins, are a class of drugs that lower your blood sugar levels by preventing your kidneys from reabsorbing sugar that is created by your body and the extra sugar leaves through in your urine. To read more, click here.
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In propensity score-matched analyses, new users of SGLT2i had a significant 43%, 38%, and 25% lower risk of vision-threatening retinopathy compared with new users of dipeptidyl peptidase-4 inhibitors (DPP-4i), sulfonylureas, and pioglitazone, respectively, Results were similar for empagliflozin, dapagliflozin, and canagliflozin. Sight-threatening retinopathy was defined as at least 2 outpatient visits or 1 hospitalization for diabetic retinopathy that required surgery, laser photocoagulation, or anti-VEGF injections (ranibizumab, bevacizumab, or aflibercept) within 90 days of diagnosis or vision loss.
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Kaplan-Meier analyses revealed that the cumulative incidence of sight-threatening retinopathy (per 1000 person-years) was significantly lower among SGLT2i users compared with DPP-4i (3.52 vs 6.13), pioglitazone (4.32 vs 5.76), and sulfonylurea (2.94 vs 4.67) users.
As per the team, in addition to playing a role in reducing the risk of diabetic nephropathy, SGLT2i may be associated with the slow progression of diabetic retinopathy.
For the study, investigators analyzed data from Taiwan’s 2009-2020 National Health Insurance Research Database (NHIRD). They identified 3,544,383 patients with newly diagnosed type 2 diabetes. After 1:1 propensity score matching, the investigators identified 65,930 pairs of patients treated with SGLT2i vs DPP-4i, 93,760 pairs treated with SGLT2i vs pioglitazone, and 42,121 pairs treated with SGLT2i vs sulfonylurea.
The NHIRD lacked information on relevant factors such as family history, smoking history, laboratory values, and retinal imaging, so data from randomized controlled trials are needed.
Slightly edited from this source.
To read the academic article in JAMA Network Open, click here.