Evidence mapPaperPMID 37794166Full record

ArticleCommunications medicine2023

Treatment effect heterogeneity following type 2 diabetes treatment with GLP1-receptor agonists and SGLT2-inhibitors: a systematic review.

Katherine G Young, Eram Haider McInnes, Robert J Massey, Anna R Kahkoska, Scott J Pilla, Sridharan Raghavan, Maggie A Stanislawski, Deirdre K Tobias, Andrew P McGovern, Adem Y Dawed and 4 more

Open access · goldAbstract read
In one paragraph

Article in Communications medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
6.6field-weighted citation impact, top 3% 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

30 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
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  9. Glycemic response trajectories on metformin monotherapy in real-world diabetes care.medRxiv : the preprint server for health sciences · 2026
    Article
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  11. GLP-1 receptor agonists or SGLT2-inhibitors? Evaluation of a personalized treatment algorithm for individuals with type 2 diabetes: a registry-based cohort study.Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association · 2026
    Observational
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  19. Focus on Semaglutide 2.4 mg/week for the Treatment of Metabolic Dysfunction-Associated Steatohepatitis.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 20 institutions in 26 countries.

Katherine G Young *Exeter Centre of Excellence in Diabetes (EXCEED), University of Exeter Medical School, RILD Building, Royal Devon & Exeter Hospital, Exeter, UK.
Eram Haider McInnes *Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK.
Robert J Massey *Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK.
Anna R KahkoskaDepartment of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Scott J PillaDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sridharan RaghavanSection of Academic Primary Care, US Department of Veterans Affairs Eastern Colorado Health Care System, Aurora, CO, USA.
Maggie A StanislawskiDepartment of Biomedical Informatics, School of Medicine, University of Colorado, Aurora, USA.ORCID http://orcid.org/0000-0001-7768-8868
Deirdre K TobiasDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Andrew P McGovernExeter Centre of Excellence in Diabetes (EXCEED), University of Exeter Medical School, RILD Building, Royal Devon & Exeter Hospital, Exeter, UK.
Adem Y DawedDivision of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK.
Angus G JonesExeter Centre of Excellence in Diabetes (EXCEED), University of Exeter Medical School, RILD Building, Royal Devon & Exeter Hospital, Exeter, UK.
Ewan R PearsonDivision of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK. e.z.pearson@dundee.ac.uk.ORCID http://orcid.org/0000-0001-9237-8585
John M DennisExeter Centre of Excellence in Diabetes (EXCEED), University of Exeter Medical School, RILD Building, Royal Devon & Exeter Hospital, Exeter, UK. j.dennis@exeter.ac.uk.ORCID http://orcid.org/0000-0002-7171-732X
ADA/EASD PDMI
Johns Hopkins University · USUniversity of Copenhagen · DKBroad Institute · USUniversity of Exeter · GBHarvard University · USUniversity of Dundee · GBNorthwestern University · USChinese University of Hong Kong · HKLund University · SEBrigham and Women's Hospital · USJoslin Diabetes Center · USNational Institutes of Health · USUniversity of Maryland, Baltimore · USUniversity of South Dakota · USHôpital Necker-Enfants Malades · FRIndiana University School of MedicineUniversity of Chicago · USUniversity of Colorado Anschutz Medical Campus · USUniversity of Pittsburgh · USBaylor College of Medicine · US

Funding

University of Colorado Anschutz Medical Campus DRCP30DK116073 · UNIVERSITY OF COLORADO DENVER · 2025 to 2025
$1.3M
The Contribution of Omic Profiles to Weight Loss and ObesityK01HL157658 · UNIVERSITY OF COLORADO DENVER · 2025 to 2025
$159k
CSRD VA IK2 CX001907Medical Research Council MR/K005707/1Medical Research Council MR/N00633X/1Medical Research Council MR/T032014/1Medical Research Council MR/W003988/1NCATS NIH HHS KL2 TR002490NHLBI NIH HHS K01 HL157658NIDDK NIH HHS P30 DK116073Wellcome Trust 210752/Z/18/Z
6 · The paper itself

Abstract

backgroundA precision medicine approach in type 2 diabetes requires the identification of clinical and biological features that are reproducibly associated with differences in clinical outcomes with specific anti-hyperglycaemic therapies. Robust evidence of such treatment effect heterogeneity could support more individualized clinical decisions on optimal type 2 diabetes therapy.

methodsWe performed a pre-registered systematic review of meta-analysis studies, randomized control trials, and observational studies evaluating clinical and biological features associated with heterogenous treatment effects for SGLT2-inhibitor and GLP1-receptor agonist therapies, considering glycaemic, cardiovascular, and renal outcomes. After screening 5,686 studies, we included 101 studies of SGLT2-inhibitors and 75 studies of GLP1-receptor agonists in the final systematic review.

resultsHere we show that the majority of included papers have methodological limitations precluding robust assessment of treatment effect heterogeneity. For SGLT2-inhibitors, multiple observational studies suggest lower renal function as a predictor of lesser glycaemic response, while markers of reduced insulin secretion predict lesser glycaemic response with GLP1-receptor agonists. For both therapies, multiple post-hoc analyses of randomized control trials (including trial meta-analysis) identify minimal clinically relevant treatment effect heterogeneity for cardiovascular and renal outcomes.

conclusionsCurrent evidence on treatment effect heterogeneity for SGLT2-inhibitor and GLP1-receptor agonist therapies is limited, likely reflecting the methodological limitations of published studies. Robust and appropriately powered studies are required to understand type 2 diabetes treatment effect heterogeneity and evaluate the potential for precision medicine to inform future clinical care.

Identifiers

PMID37794166
PMCPMC10551026
OpenAlexW4387345288

What Socratic holds

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LicenceCC BY
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Registered trials

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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.