Evidence mapPaperPMID 38779879Full record

ArticleDiabetes, obesity & metabolism2024

Comparative safety and cardiovascular effectiveness of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in nursing homes.

Melissa R Riester, Andrew R Zullo, Richa Joshi, Lori A Daiello, Kaleen N Hayes, Darae Ko, Dae Hyun Kim, Medha Munshi, Sarah D Berry

Abstract readComparative Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
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

9 authors.

Melissa R RiesterDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-2196-0134
Andrew R ZulloDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.ORCID 0000-0003-1673-4570
Richa JoshiCenter for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Lori A DaielloCenter for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Kaleen N HayesCenter for Gerontology and Healthcare Research, Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Darae KoHinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Hebrew SeniorLife, Boston, Massachusetts, USA.
Dae Hyun KimHinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Hebrew SeniorLife, Boston, Massachusetts, USA.
Medha MunshiDepartment of Medicine, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0001-6917-4197
Sarah D BerryHinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Hebrew SeniorLife, Boston, Massachusetts, USA.

Funding

Clinically Significant Drug Interactions among Nursing Home Residents with ADRDR01AG077620 · BROWN UNIVERSITY · 2025 to 2025
$693k
Benefits and Harms of Long-term Osteoporosis Pharmacotherapy: Impact of Treatment Length, Type, Switching, and HolidaysR01AG078759 · BROWN UNIVERSITY · 2025 to 2025
$615k
Mid-Career Mentoring Award For Patient-Oriented Research in Frailty and Health OutcomesK24AG073527 · HEBREW REHABILITATION CENTER FOR AGED · 2025 to 2025
$172k
NIA NIH HHS K24 AG073527NIA NIH HHS K24AG073527NIA NIH HHS R01 AG065722NIA NIH HHS R01AG065722NIA NIH HHS R01 AG077620NIA NIH HHS R01AG077620NIA NIH HHS R01 AG078759NIA NIH HHS R01AG078759NIA NIH HHS RF1 AG061221NIA NIH HHS RF1AG061221
6 · The paper itself

Abstract

aimStudies examining the safety and effectiveness of sodium-glucose cotransporter-2 inhibitors (SGLT2is) versus glucagon-like peptide-1 receptor agonists (GLP-1RAs) among community-dwelling adults may not generalize to nursing home (NH) residents, who are typically older and more multimorbid. We compared the safety and cardiovascular effectiveness of SGLT2is and GLP-1RAs among US NH residents. MATERIALS AND

methodsEligible individuals were aged ≥66 years with type 2 diabetes mellitus and initiated an SGLT2i or GLP-1RA in an NH between 2013 and 2018. Safety outcomes included fall-related injuries, hypoglycaemia, diabetic ketoacidosis (DKA), urinary tract infection or genital infection, and acute kidney injury in the year following treatment initiation. Cardiovascular effectiveness outcomes included death, major adverse cardiovascular events and hospitalization for heart failure. Per-protocol adjusted hazard ratios (HR) were calculated using stabilized inverse probability of treatment and censoring weighted cause-specific hazard regression models accounting for 127 covariates.

resultsThe study population included 7710 residents (31.08% SGLT2i, 68.92% GLP-1RA). Compared with GLP-1RA initiators, SGLT2i initiators had higher rates of DKA (HR 1.95, 95% confidence limits 1.27, 2.99) and death (HR 1.18, 95% confidence limits 1.02, 1.36). Rates of urinary tract infection or genital infection, acute kidney injury, major adverse cardiovascular events, and heart failure were also elevated, while rates of fall-related injuries and hypoglycaemia were reduced, but all estimates were imprecise and highly compatible with no difference.

conclusionsSGLT2is do not have superior, and may have inferior, effectiveness compared with GLP-1RAs for cardiovascular and mortality outcomes in NH residents. Residents initiating SGLT2is should be monitored closely for DKA.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsNursing HomesSodium-Glucose Transporter 2 InhibitorsAcute Kidney InjuryAgedAged, 80 and overFemaleHumansHypoglycemiaHypoglycemic AgentsMaleTreatment OutcomeGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorseffectivenessglucagon‐like peptide‐1observational studypharmaco‐epidemiologysodium‐glucose cotransporter‐2 inhibitor

Identifiers

PMID38779879
PMCPMC11233240

What Socratic holds

Textmetadata
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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.