- Drug/Regimen
- Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists
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Tzu-Yi Lin, Eugene Yu-Chuan Kang, Shih-Chieh Shao, Edward Chia-Cheng Lai, Sunir J. Garg, Kuan-Jen Chen, Je-Ho Kang, Wei-Chi Wu, Chi-Chun Lai, Yih-Shiou Hwang
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Diabetes Metab J. 2023;47(3):394-404. Published online March 6, 2023
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DOI: https://doi.org/10.4093/dmj.2022.0221
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 Abstract
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- Background
To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.
Methods
This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.
Results
There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).
Conclusion
Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.
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Citations
Citations to this article as recorded by  - Impact of glucagon‐like peptide‐1 receptor agonists on diabetic retinopathy: A meta‐analysis of clinical studies emphasising retinal changes as a primary outcome
Ishani Kapoor, Swara M. Sarvepalli, David A. D'Alessio, Majda Hadziahmetovic
Clinical & Experimental Ophthalmology.2025; 53(1): 67. CrossRef - SGLT2 inhibitors and diabetic retinopathy: Insights from the management of nephropathy
Maria S. Varughese, Lakshminarayanan Varadhan
Eye.2025; 39(2): 213. CrossRef - Impact of Obstructive Sleep Apnea on Diabetic Retinopathy Progression and Systemic Complications
Ehsan Rahimy, Euna B. Koo, Karen M. Wai, Cassie A. Ludwig, Andrea L. Kossler, Prithvi Mruthyunjaya
American Journal of Ophthalmology.2025; 270: 93. CrossRef - An update on ocular effects of antidiabetic medications
Elham Sadeghi, Elham Rahmanipour, Nicola Valsecchi, Saloni Kapoor, Maria Vittoria Cicinelli, Jay Chhablani
Survey of Ophthalmology.2025;[Epub] CrossRef - Glucagon-like peptide-1 receptor agonists and the eye
David L. Zhang, Avni P. Finn
Current Opinion in Ophthalmology.2025;[Epub] CrossRef - Incretin‐based drugs and the risk of diabetic retinopathy among individuals with type 2 diabetes: A systematic review and meta‐analysis of observational studies
Samuel Igweokpala, Naheemot Olaoluwa Sule, Antonios Douros, Oriana H. Y. Yu, Kristian B. Filion
Diabetes, Obesity and Metabolism.2024; 26(2): 721. CrossRef - Association of sodium–glucose cotransporter‐2 inhibitors and the risk of retinal vascular occlusion: A real‐world retrospective cohort study in Taiwan
Tzu‐Yi Lin, Eugene Yu‐Chuan Kang, Shih‐Chieh Shao, Edward Chia‐Cheng Lai, Nan‐Kai Wang, Sunir J. Garg, Kuan‐Jen Chen, Je‐Ho Kang, Wei‐Chi Wu, Chi‐Chun Lai, Yih‐Shiou Hwang
Diabetes/Metabolism Research and Reviews.2024;[Epub] CrossRef - Risk of rotator cuff tear and rotator cuff repair surgery comparison between sodium-glucose cotransporter 2 inhibitors and glucagon like peptide-1 receptor agonists: A real-world study
Yu-Chi Su, Pei-Chun Hsieh, Edward Chia-Cheng Lai, Yu-Ching Lin
Diabetes & Metabolism.2024; 50(2): 101522. CrossRef - Optimising renal risk parameters in type 2 diabetes mellitus: Perspectives from a retinal viewpoint
Sarita Jacob, George I. Varughese
Clinical Medicine.2024; 24(2): 100031. CrossRef - Risk of diabetic retinopathy and diabetic macular oedema with sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in type 2 diabetes: a real-world data study from a global federated database
Aikaterini Eleftheriadou, David Riley, Sizheng S. Zhao, Philip Austin, Gema Hernández, Gregory Y. H. Lip, Timothy L. Jackson, John P. H. Wilding, Uazman Alam
Diabetologia.2024; 67(7): 1271. CrossRef - Impact of GLP-1 Agonists and SGLT-2 Inhibitors on Diabetic Retinopathy Progression: An Aggregated Electronic Health Record Data Study
Karen M. Wai, Kapil Mishra, Euna Koo, Cassie Ann Ludwig, Ravi Parikh, Prithvi Mruthyunjaya, Ehsan Rahimy
American Journal of Ophthalmology.2024; 265: 39. CrossRef - Comparative Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists, Sodium-Glucose Cotransporter 2 Inhibitors, Dipeptidyl Peptidase-4 Inhibitors, and Sulfonylureas for Sight-Threatening Diabetic Retinopathy
Andrew J. Barkmeier, Jeph Herrin, Kavya Sindhu Swarna, Yihong Deng, Eric C. Polley, Guillermo E. Umpierrez, Rodolfo J. Galindo, Joseph S. Ross, Mindy M. Mickelson, Rozalina G. McCoy
Ophthalmology Retina.2024; 8(10): 943. CrossRef - Association Between Pentoxifylline Use and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Multi-Institutional Cohort Study
Tzu-Yi Lin, Eugene Yu-Chuan Kang, Nan-Kai Wang, Je-Ho Kang, Kuan-Jen Chen, Wei-Chi Wu, Chi-Chun Lai, Yih-Shiou Hwang
Biomedical Journal.2024; : 100771. CrossRef - Association between sodium-glucose cotransporter 2 inhibitors and eye disorders: a systematic review and meta-analysis
Bo Xu, Bo Kang, Fan Tang, Jiecan Zhou, Zunbo He
Expert Review of Clinical Pharmacology.2024; 17(10): 949. CrossRef - Comparison of the Risk of Diabetic Retinopathy Between Sodium-Glucose Cotransporter-2 Inhibitors and Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus in Japan: A Retrospective Analysis of Real-World Data
Masaya Koshizaka, Tomoaki Tatsumi, Fumiko Kiyonaga, Yoshinori Kosakai, Yoko Yoshinaga, Mami Shintani-Tachi
Diabetes Therapy.2024; 15(11): 2401. CrossRef - NOVEL AGENTS IN THE MANAGEMENT OF DIABETES AND RISK OF WORSENING DIABETIC RETINOPATHY
Rithwick Rajagopal, Janet B. McGill
Retina.2024; 44(11): 1851. CrossRef - Mechanism and therapeutic targets of circulating immune cells in diabetic retinopathy
Bowen Zhao, Yin Zhao, Xufang Sun
Pharmacological Research.2024; 210: 107505. CrossRef - Diabetes Renders Photoreceptors Susceptible to Retinal Ischemia-Reperfusion Injury
David A. Antonetti, Cheng-Mao Lin, Sumathi Shanmugam, Heather Hager, Manjing Cao, Xuwen Liu, Alyssa Dreffs, Adam Habash, Steven F. Abcouwer
Investigative Ophthalmology & Visual Science.2024; 65(13): 46. CrossRef - Multi-omics in exploring the pathophysiology of diabetic retinopathy
Xinlu Li, XiaoJing Dong, Wen Zhang, Zhizhou Shi, Zhongjian Liu, Yalian Sa, Li Li, Ninghua Ni, Yan Mei
Frontiers in Cell and Developmental Biology.2024;[Epub] CrossRef - Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists (Diabetes Metab J 2023;47:394-404)
Tzu-Yi Lin, Eugene Yu-Chuan Kang, Shih-Chieh Shao, Edward Chia-Cheng Lai, Yih-Shiou Hwang
Diabetes & Metabolism Journal.2023; 47(4): 573. CrossRef - Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists (Diabetes Metab J 2023;47:394-404)
Jihee Ko, Sun Joon Moon
Diabetes & Metabolism Journal.2023; 47(4): 571. CrossRef - Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Retinopathy in Patients With Type 2 Diabetes
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JAMA Network Open.2023; 6(12): e2348431. CrossRef
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