Evidence mapPaperPMID 39364788Full record

ArticleJournal of diabetes2024

Comparing Glucagon-like peptide-1 receptor agonists versus metformin in drug-naive patients: A nationwide cohort study.

Kathrine Kold Sørensen, Thomas Alexander Gerds, Lars Køber, Emil Loldrup Fosbøl, Henrik Enghusen Poulsen, Amalie Lykkemark Møller, Mikkel Porsborg Andersen, Ulrik Pedersen-Bjergaard, Christian Torp-Pedersen, Bochra Zareini

Abstract readComparative Study
In one paragraph

Article in Journal of diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

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

  1. Pooled it
  2. Article
  3. A scoping review of real-world evidence generation methods to estimate the safety of type 2 diabetes medications on fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Review
  4. Review
  5. Review
  6. A cohort description and comparison of four European national diabetes registries for the REDDIE project.Diabetic medicine : a journal of the British Diabetic Association · 2025
    Article
  7. Article
  8. Review
  9. Article
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

10 authors.

Kathrine Kold SørensenDepartment of Cardiology, Nordsjælland Hospital, Hillerød, Denmark.ORCID https://orcid.org/0000-0002-9402-1317
Thomas Alexander GerdsSection of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Lars KøberThe Heart Centre, University Hospital of Copenhagen, Denmark.
Emil Loldrup FosbølThe Heart Centre, University Hospital of Copenhagen, Denmark.
Henrik Enghusen PoulsenDepartment of Endocrinology, University Hospital Copenhagen, Frederiksberg, Denmark.
Amalie Lykkemark MøllerSection of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Mikkel Porsborg AndersenDepartment of Cardiology, Nordsjælland Hospital, Hillerød, Denmark.
Ulrik Pedersen-BjergaardDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Christian Torp-PedersenDepartment of Cardiology, Nordsjælland Hospital, Hillerød, Denmark.
Bochra ZareiniDepartment of Cardiology, Nordsjælland Hospital, Hillerød, Denmark.ORCID https://orcid.org/0000-0002-3891-5957

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlucagon-like peptide-1 receptor agonists (GLP-1 RA) are increasingly being prescribed in drug-naive patients. We aimed to contrast add-on therapy, adherence, and changes in biomarkers, 1 year after treatment initiation with GLP-1 RA or metformin.

methodsUsing Danish nationwide registers, we included incident GLP-1 RA or metformin users from 2018 to 2021 with glycated hemoglobin (HbA1c) ≥ 42 mmol/mol. GLP-1 RA initiators were matched to metformin initiators in a ratio of 1:1 to assess outcomes in prediabetes and diabetes. Main outcomes analyzed were 1-year risk of add-on glucose-lowering medication and 1-year risk of nonadherence. One-year risks were estimated with multiple logistic regression and standardized. Multiple linear regression was used to estimate the average differences in biomarker changes.

resultsIn total, 1778 individuals initiating GLP-1 RA and metformin were included. After standardizing for various factors, GLP-1 RA compared with metformin was associated with reduced 1-year risk of add-on glucose-lowering treatment in patients with prediabetes (1-year risk ratio [RR]: 0.27, 95% confidence interval [CI]: 0.10-0.44) and diabetes (RR: 0.67, 95% CI: 0.37-0.98). GLP-1 RA was associated with higher 1-year risk of nonadherence among patients with prediabetes (RR: 1.60, 95% CI: 1.45-1.75), but no difference in patients with diabetes (RR: 0.88, 95% CI: 0.70-1.06). Compared to metformin, GLP-1 RA was associated with greater HbA1c reduction (prediabetes: -2.59 mmol/mol 95% CI: -3.10 to -2.09, diabetes: -3.79 mmol/mol, 95% CI: -5.28 to -2.30).

conclusionsGLP-1 RA was associated with a reduced risk of additional glucose-lowering medication, achieving better glycated hemoglobin control overall. However, among patients with prediabetes, metformin was associated with better adherence.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsGlycated HemoglobinHypoglycemic AgentsMetforminAdultAgedBiomarkersBlood GlucoseCohort StudiesDenmarkDrug MonitoringFemaleHumansMaleMiddle AgedBiomarkersBlood GlucoseGlucagon-Like Peptide-1 Receptor AgonistsGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsMetformin

Identifiers

PMID39364788
PMCPMC11450598

What Socratic holds

Texttitle and abstract
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.