ArticleDiabetes, obesity & metabolism2025
The effect of sodium-glucose cotransporter 2 inhibitors on HbA1c variability and cardiovascular and renal adverse outcome in patients with T2DM.
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.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glycemic variability of glycated hemoglobin in patients with type 2 diabetes mellitus and the risk of cardiovascular diseases: a latest systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- The effect of sodium-glucose cotransporter 2 inhibitors on HbA1c variability and cardiovascular and renal adverse outcome in patients with T2DM.Diabetes, obesity & metabolism · 2025Article
- The effect of HbA1C variability on the development and progression of diabetic nephropathy.Frontiers in clinical diabetes and healthcare · 2025Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
aimsTo compare the effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors in reducing haemoglobin A1c (HbA1c) variability and improving cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and high HbA1c variability.
methodsThis territory-wide cohort study involved patients with T2DM and an HbA1c variability score (HVS) >60% who initiated SGLT2 inhibitors or DPP-4 inhibitors in Hong Kong between 2015 and 2022. Propensity score (PS) matching was used to adjust for confounders. The primary outcome was post-treatment HVS within 3 years. Secondary outcomes included major adverse cardiovascular events (MACE) and serious renal events (SRE).
resultsAmong 20,205 T2DM patients with a baseline HVS >60%, 4,612 SGLT2 inhibitor users were 1:1 matched with DPP-4 inhibitor users. When referencing the 0%-20% quintile, patients initiating SGLT2 inhibitors versus DPP-4 inhibitors exhibited a reduced likelihood of being in higher HVS quintiles [21%-40%: odds ratio (OR) 0.76, 95% confidence interval (CI) 0.66-0.88; 41%-60%: OR 0.57, 95% CI 0.50-0.65; 61%-80%: OR 0.49, 95% CI 0.42-0.56; and 81%-100%: OR 0.40, 95% CI 0.34-0.47]. SGLT2 inhibitors were associated with a reduced risk of MACE [hazard ratio (HR) 0.69; 95% CI 0.60-0.79] and SRE (HR 0.71; 95% CI 0.63-0.80) compared to DPP-4 inhibitors.
conclusionIn patients with high HbA1c variability, SGLT2 inhibitor initiation was associated with superior effectiveness in reducing HbA1c variability compared to DPP-4 inhibitors. The initiation of SGLT2 inhibitors versus DPP-4 inhibitors was linked to significantly reduced cardiovascular and renal adverse events.
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