Evidence map›Paper›PMID 34774054›Full record

Observational studyCardiovascular diabetology2021

Cardiovascular outcomes after initiating GLP-1 receptor agonist or basal insulin for the routine treatment of type 2 diabetes: a region-wide retrospective study.

Enrico Longato, Barbara Di Camillo, Giovanni Sparacino, Lara Tramontan, Angelo Avogaro, Gian Paolo Fadini

Open access · goldAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Basal Insulin Adherence in Patients with Type 2 Diabetes Mellitus in Routine Clinical Practice in Spain: Clinical and Economic Impact.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Enrico LongatoDepartment of Information Engineering, University of Padova, 35100, Padova, Italy.
Barbara Di CamilloDepartment of Information Engineering, University of Padova, 35100, Padova, Italy.
Giovanni SparacinoDepartment of Information Engineering, University of Padova, 35100, Padova, Italy.
Lara TramontanArsenàl.IT, Veneto's Research Centre for eHealth Innovation, 31100, Treviso, Italy.
Angelo AvogaroDepartment of Medicine, University of Padova, Via Giustiniani 2, 35100, Padova, Italy.
Gian Paolo FadiniDepartment of Medicine, University of Padova, Via Giustiniani 2, 35100, Padova, Italy. gianpaolo.fadini@unipd.it.ORCID 0000-0002-6510-2097
University of Padua · IT

Funding

Ministero dell'Istruzione, dell'Università e della Ricerca Departments of Excellence
6 · The paper itself

Abstract

aimWe aimed to compare cardiovascular outcomes of patients with type 2 diabetes (T2D) who initiated GLP-1 receptor agonists (GLP-1RA) or basal insulin (BI) under routine care.

methodsWe accessed the administrative claims database of the Veneto Region (Italy) to identify new users of GLP-1RA or BI in 2014-2018. Propensity score matching (PSM) was implemented to obtain two cohorts of patients with superimposable characteristics. The primary endpoint was the 3-point major adverse cardiovascular events (3P-MACE). Secondary endpoints included 3P-MACE components, hospitalization for heart failure, revascularizations, and adverse events.

resultsFrom a background population of 5,242,201 citizens, 330,193 were identified as having diabetes. PSM produced two very well matched cohorts of 4063 patients each, who initiated GLP-1RA or BI after an average of 2.5 other diabetes drug classes. Patients were 63-year-old and only 15% had a baseline history of cardiovascular disease. During a median follow-up of 24 months in the intention-to-treat analysis, 3P-MACE occurred less frequently in the GLP-1RA cohort (HR versus BI 0.59; 95% CI 0.50-0.71; p < 0.001). All secondary cardiovascular endpoints were also significantly in favor of GLP-1RA. Results were confirmed in the as-treated approach and in several stratified analyses. According to the E-value, confounding by unmeasured variables were unlikely to entirely explain between-group differences in cardiovascular outcomes.

conclusionsPatients with T2D who initiated a GLP-1RA experienced far better cardiovascular outcomes than did matched patients who initiated a BI in the same healthcare system. These finding supports prioritization of GLP-1RA as the first injectable regimen for the management of T2D.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsAdministrative Claims, HealthcareAgedAged, 80 and overCardiovascular DiseasesComparative Effectiveness ResearchDatabases, FactualDiabetes Mellitus, Type 2FemaleGlucagon-Like Peptide-1 ReceptorHumansHypoglycemic AgentsIncretinsInsulinItalyLongitudinal StudiesGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsIncretinsInsulinEffectivenessGuidelinesObservationalPharmacotherapyReal world

Identifiers

PMID34774054
PMCPMC8590792
OpenAlexW3213032930

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.