Evidence map›Paper›PMID 38636788›Full record

ArticleAmerican journal of ophthalmology2024

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

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
15.0field-weighted citation impact, top 1% 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

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

  1. Pooled it
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  9. Semaglutide and diabetic retinopathy: an OHDSI network study.BMJ open diabetes research & care · 2025 · on this map
    Observational
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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

7 authors at 4 institutions in 1 country.

Karen M WaiFrom the Department of Ophthalmology (K.M.W., E.K., C.A.L., P.M., E.R.), Byers Eye Institute, Stanford University, Palo Alto, California, USA.
Kapil MishraDepartment of Ophthalmology, UCI Health (K.M.), Gavin Herbert Eye Institute, Irvine, California, USA.
Euna KooFrom the Department of Ophthalmology (K.M.W., E.K., C.A.L., P.M., E.R.), Byers Eye Institute, Stanford University, Palo Alto, California, USA.
Cassie Ann LudwigFrom the Department of Ophthalmology (K.M.W., E.K., C.A.L., P.M., E.R.), Byers Eye Institute, Stanford University, Palo Alto, California, USA.
Ravi ParikhDepartment of Ophthalmology, Grossman School of Medicine (R.P.), NYU Langone Health, New York, New York, USA; Manhattan Retina and Eye Consultants (R.P.), New York, New York, USA.
Prithvi MruthyunjayaFrom the Department of Ophthalmology (K.M.W., E.K., C.A.L., P.M., E.R.), Byers Eye Institute, Stanford University, Palo Alto, California, USA.
Ehsan RahimyFrom the Department of Ophthalmology (K.M.W., E.K., C.A.L., P.M., E.R.), Byers Eye Institute, Stanford University, Palo Alto, California, USA; Department of Ophthalmology (E.R.), Palo Alto Medical Foundation, Palo Alto, California, USA. Electronic address: erahimy@gmail.com.
Smith-Kettlewell Eye Research Institute · USPalo Alto Institute · USUC Irvine Health · USVitreous Retina Macula Consultants of New York · US

Funding

Stanford Vision Research CoreP30EY026877 · STANFORD UNIVERSITY · 2025 to 2025
$738k
Stanford K12 Clinician-Scientist Career Development ProgramK12EY033745 · STANFORD UNIVERSITY · 2025 to 2025
$513k
Artificial Intelligence Analysis of Myopic Vitreoretinal PathologyK23EY035741 · STANFORD UNIVERSITY · 2025 to 2025
$274k
NEI NIH HHS K12 EY033745NEI NIH HHS K23 EY035741NEI NIH HHS P30 EY026877
6 · The paper itself

Abstract

purposeTo examine the effects of glucagon-like peptide-1 receptor (GLP-1) agonists compared to SGLT-2 inhibitors on diabetic retinopathy.

designRetrospective clinical cohort study using TriNetX, a federated electronic health records network comprising multiple healthcare organizations.

methodsPatients with an International Classification of Diseases, Tenth Revision (ICD-10) code of nonproliferative diabetic retinopathy (PDR) and monotherapy treatment, excluding insulin, with GLP-1 agonists or SGLT-2 inhibitors. Patients with a history of PDR prior to initiation of treatment were excluded. The rate of progression to PDR and rate of development of diabetic macular edema (DME) were compared between patients on GLP-1 agonists compared to those on SGLT-2 inhibitors. The groups were propensity score matched for age, gender, ethnicity, race, type of diabetes, and severity of PDR. Main outcomes included rate and relative risk (RR) of progression to PDR and risk of DME in the GLP-1 agonist group versus the SGLT-2 inhibitor group.

resultsA total of 6481 patients were identified in the GLP-1 cohort and the SGLT-2 inhibitor cohort after propensity score matching. At 1 and 3 years after initiation of therapy, a higher rate of progression of PDR was noted (RR: 1.26, CI 1.04-1.51, P = .017 at 1 year, RR: 1.284, CI 1.1-1.499, P = .002 at 3 years) in the GLP-1 agonist cohort compared to the SGLT-2 inhibitor cohort. There was a higher rate of DME noted at 3 months (RR: 1.192, CI 1.059-1.276, P = .002), 6 months (RR: 1.22, CI 1.13-1.32, P < .001), 1 year (RR: 1.24, CI 1.15-1.33, P < .001), and at 3 years (RR: 1.29, CI 1.21-1.38, P < .001) in the GLP-1 agonist cohort compared to the SGLT-2 inhibitor cohort.

conclusionsA higher rate of progression of PDR and risk of new-onset DME was observed in patients on monotherapy with GLP-1 agonists compared to those on SGLT-2 inhibitors. It is important for clinicians to be aware of these potential effects and to consider the current retinopathy status when initiating treatment with newer hypoglycemic agents to ensure these patients are appropriately monitored for developing potential vision-threatening complications.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyDisease ProgressionElectronic Health RecordsGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 InhibitorsAgedBlood GlucoseFemaleFollow-Up StudiesGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedRetrospective StudiesBlood GlucoseGlucagon-Like Peptide-1 Receptor AgonistsGlycated HemoglobinHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID38636788
PMCPMC12145121
OpenAlexW4394893435

What Socratic holds

Textmetadata
LicenceTDM
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.