Evidence mapPaperPMID 40735916Full record

ArticleDiabetes, obesity & metabolism2025

Glycemic therapies and the risk of gastrointestinal adverse events in veterans with type 2 diabetes.

Amara Sarwal, Ravinder Singh, Guo Wei, Jincheng Shen, McKenna Nevers, Sydney E Hartsell, Catherine G Derington, Augustine Takyi, Akhil R Chakravartula, Niharika Katkam and 4 more

Abstract read
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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
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. Article
  2. Article
  3. Review
  4. Article
  5. 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

14 authors.

Amara SarwalDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Ravinder SinghCardio-Renal & Metabolism Center, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Guo WeiDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Jincheng ShenDivision of Biostatistics, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA.
McKenna NeversDivision of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Sydney E HartsellDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Catherine G DeringtonDivision of Cardiology, Department of Medicine, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, Colorado, USA.
Augustine TakyiDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Akhil R ChakravartulaDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Niharika KatkamDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Robert E BoucherDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Stavros G DrakosCardio-Renal & Metabolism Center, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Tom GreeneDivision of Biostatistics, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Srinivasan BeddhuDivision of Nephrology and Hypertension, Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0002-3312-315X

Funding

CTSA UM1 Program at University of UtahUM1TR004409 · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2025 to 2025
$5.4M
TRAINING IN CARDIOVASCULAR RESEARCHT32HL007576 · NHLBI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 1985 to 2025
$2.7M
Sit Less, Interact and Move More (SLIMM) 2 StudyR01DK128640 · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2025 to 2025
$636k
Objectively Measured Sedentary Behavior and Physical Activity in PREVENTABLE StudyR01AG074592 · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2025 to 2025
$519k
MSRP in Metabolism, Diabetes, Digestive and Kidney DiseasesT35DK103596 · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2025 to 2025
$72k
NCATS NIH HHS 5UL1TR001067-05NCATS NIH HHS 8UL1TR000105NCATS NIH HHS UL1RR025764NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR001067NCATS NIH HHS UM1 TR004409NCATS NIH HHS UM1TR004409NCRR NIH HHS UL1 RR025764NHLBI NIH HHS T32 HL007576NIA NIH HHS R01 AG074592NIDDK NIH HHS R01 DK128640NIDDK NIH HHS T35 DK103596Veterans Health Administration Office of Rural Health
6 · The paper itself

Abstract

aimsTo compare the risk of gastrointestinal adverse events in new users of glucagon-like peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors (SGLT2i) and insulin glargine. MATERIALS AND

methodsWe conducted an active comparator, new user design study in veterans with type 2 diabetes who initiated one of these drug classes between 1 January 2018 and 31 December 2021 (N = 141 080). Inverse probability weighted Cox regression models were used to relate drug class to outcomes of gastroparesis, intestinal obstruction, gallstones, acute cholecystitis, acute pancreatitis and all-cause death.

resultsThere were 19 765 (14.0%) veterans initiated on GLP-1RA, 75 058 (53.2%) on SGLT2i and 46 257 (32.8%) on insulin glargine. Compared to SGLT2i, GLP-1RA had a higher hazard of gastroparesis (HR 1.65, 95% CI 1.33-2.05) but a similar mortality hazard. Compared to insulin glargine, GLP-1RA had a higher hazard of gastroparesis (HR 1.24, 95% CI 1.02, 1.52), but a lower hazard of all-cause death (HR 0.62, 95% CI 0.58, 0.66). Compared to SGLT2i, insulin glargine had a higher hazard of gastroparesis (HR 1.29, 95% CI 1.07, 1.56), intestinal obstruction (HR 1.26, 95% CI 1.11, 1.43) and all-cause death (HR 1.58, 95% CI 1.50, 1.65). Risks of gallstones, acute cholecystitis and pancreatitis were similar across the classes.

conclusionsIn patients with type 2 diabetes at risk for gastroparesis, SGLT2i might be the preferred agent. In patients for whom SGLT2i is not an option or another agent is needed, patients and providers might need to weigh the higher risk of death with insulin glargine against the higher risk of gastroparesis with GLP-1RA.

Indexed as

Diabetes Mellitus, Type 2Gastrointestinal DiseasesHypoglycemic AgentsInsulin GlargineSodium-Glucose Transporter 2 InhibitorsAgedFemaleGlucagon-Like Peptide-1 Receptor AgonistsHumansMaleMiddle AgedRisk FactorsVeteransGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsInsulin GlargineSodium-Glucose Transporter 2 Inhibitorsantidiabetic drugdatabase researchGLP‐1insulin glargineSGLT2 inhibitor

Identifiers

PMID40735916
PMCPMC12409243

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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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.