Evidence map›Paper›PMID 40400097›Full record

ArticleDiabetes, obesity & metabolism2025

Long-term outcomes following alternative second-line oral glucose-lowering treatments: Results from the real-world progression in type 2 diabetes mellitus United Kingdom (RAPIDS-UK) model.

Orlagh U Carroll, Patrick Bidulka, Anirban Basu, Amanda I Adler, Stephen O'Neill, Andrew H Briggs, David G Lugo-Palacios, Kamlesh Khunti, Richard Grieve

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Article
  3. 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

9 authors.

Orlagh U CarrollDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Patrick BidulkaDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0001-7644-2030
Anirban BasuThe Comparative Health Outcomes, Policy & Economics (CHOICE) Institute, University of Washington School of Pharmacy, Seattle, Washington, USA.ORCID https://orcid.org/0000-0003-4238-7402
Amanda I AdlerDiabetes Trials Unit, The Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OCDEM Building Churchill Hospital, Headington, UK.
Stephen O'NeillDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Andrew H BriggsDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
David G Lugo-PalaciosDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.ORCID https://orcid.org/0000-0003-2343-7099
Richard GrieveDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0001-8899-1301

Funding

Health Technology Assessment Programme NIHR128490NIHR Applied Research Collaboration East MidlandsNIHR Cross NIHR Collaboration for Multiple Long Term ConditionsNIHR Global Research Centre for Multiple Long Term ConditionsNIHR Leicester Biomedical Research Centre (BRC)NIHR Oxford Biomedical Research Centre (BRC)
6 · The paper itself

Abstract

aimsTo compare long-term complications for people with type 2 diabetes mellitus (T2DM) following second-line treatment in routine practice with sulphonylureas (SU), dipeptidyl peptidase-4 inhibitors (DPP4i), or sodium-glucose co-transporter-2 inhibitors (SGLT2i) added to metformin. MATERIALS AND

methodsWe used the RAPIDS microsimulation model to predict diabetes complications over 5 years after second-line treatment initiation. We combined information on 'real-world' treatment duration in England from the Clinical Practice Research Datalink with evidence on treatment effectiveness from Randomised Controlled Trials (RCTs). We estimated between-treatment differences in the probabilities of end-stage kidney disease (ESKD), heart failure hospitalisation (HF), diabetic eye disease, myocardial infarction (MI), and lower-extremity amputation (LEA).

resultsThe predicted probabilities of complications within 5 years were lower following second-line treatment with SGLT2i compared to SU and DPP4i. The mean (95% CI) difference (reduction) in the predicted probability of ESKD following SGLT2i versus SU was -0.81% (-0.89, -0.73), and for SGLT2i versus DPP4i the corresponding difference was -0.87% (-0.95, -0.79). The reduction in the probability of HF following SGLT2i versus SU was -0.90% (-1.01, -0.80), and for SGLT2i versus DPP4i it was -0.95% (-1.06, -0.84). The corresponding differences in the probabilities of diabetic eye disease following SGLT2i versus SU were -1.41% (-1.57, -1.26), and for SGLT2i versus DPP4i was -0.44% (-0.59, -0.29). The predicted probabilities of LEA were similar across treatments. Pre-existing CVD did not modify the predicted probabilities of complications.

conclusionsFor a general T2DM population, second-line treatment with SGLT2i rather than SU or DPP4i can reduce the probability of complications within 5 years.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsAgedDiabetic NephropathiesDipeptidyl-Peptidase IV InhibitorsDisease ProgressionDrug Therapy, CombinationFemaleHumansKidney Failure, ChronicMaleMetforminMiddle AgedSulfonylurea CompoundsTreatment OutcomeDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsMetforminSodium-Glucose Transporter 2 InhibitorsSulfonylurea Compoundsdiabetes complicationseffectivenesshealth economicsreal‐world evidenceSGLT2 inhibitortype 2 diabetes

Identifiers

PMID40400097
PMCPMC12232352

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.