Evidence map›Paper›PMID 41454299›Full record

SynthesisBMC cardiovascular disorders2025

SGLT2 inhibitors versus GLP-1 receptor agonists for major adverse cardiovascular events in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials.

Ali Abdelhaleem Omar Ahmed, Omer Abdalhaleem Omer Ahmed, Reem Abdelhaleem Omar Ahmed, Rana Abdelhaleem Omar Ahmed, Mawahib Ahmed Eltayeb Abdullah Mohammed, Yara Ahmed, Mahmood Abbas, Mamdoh Abbas Ali Ibrahim, Mugtaba Eltag Mohammed Abakar, Kamal Eldeen M Dahab and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. 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

13 authors.

Ali Abdelhaleem Omar AhmedFaculty of Medicine, National Ribat University, Khartoum, Sudan. ali7haleem@gmail.com.
Omer Abdalhaleem Omer AhmedFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Reem Abdelhaleem Omar AhmedFaculty of Medicine, National Ribat University, Khartoum, Sudan.
Rana Abdelhaleem Omar AhmedFaculty of Medicine, National Ribat University, Khartoum, Sudan.
Mawahib Ahmed Eltayeb Abdullah MohammedFaculty of Medicine, University of Gezira, Wad Madani, Gezira, Sudan.
Yara AhmedFaculty of Medicine, University of Medical Sciences & Technology (UMST), Khartoum, Sudan.
Mahmood AbbasFaculty of Medicine, National Ribat University, Khartoum, Sudan.
Mamdoh Abbas Ali IbrahimFaculty of Medicine, Sudan International University, Khartoum, Sudan.
Mugtaba Eltag Mohammed AbakarFaculty of Medicine, Sudan International University, Khartoum, Sudan.
Kamal Eldeen M DahabFaculty of Medicine, University of Khartoum, Khartoum, Sudan.
Roaa Mohamed Ali ElbashirBarnsley Hospital NHS Foundation Trust, Barnsley, England.
Khalid H MohamedSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England.
Maram Adil MansourNational University Sudan, Khartoum, Sudan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular disease is the leading cause of morbidity and mortality in type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to reduce cardiovascular risk, but direct comparison is limited. Objective: Compare the effects of SGLT2 inhibitors and GLP-1 receptor agonist on major adverse cardiovascular events (MACE) in adults with T2DM using randomized controlled trials and indirect comparisons.

methodsA systematic search of PubMed, Scopus, CENTRAL, and Google Scholar was conducted through October 20, 2025, following PRISMA 2020 guidelines. The protocol was registered with PROSPERO (CRD420251168485). We included randomized controlled trials (RCTs) of SGLT2i or GLP-1RA versus placebo in adults with T2DM that reported cardiovascular or renal outcomes. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using the generic inverse variance method with a random-effects model. An indirect treatment comparison was performed using the Bucher method. Risk of bias was assessed with the Cochrane RoB 1 tool.

resultsWe reviewed twelve trials involving 99,261 individuals (5 SGLT2i, 7 GLP-1RA). Compared to placebo, SGLT2i significantly reduced MACE (HR 0.89, 95% CI 0.84–0.95; p = 0.0003), as did GLP-1RA (HR 0.82, 95% CI 0.78–0.87; p < 0.00001). The indirect comparison indicated a nominally greater MACE reduction with GLP-1RA (HR 1.09, 95% CI 1.00–1.18; p = 0.0497). SGLT2i demonstrated pronounced benefits for heart failure hospitalization (HR 0.68) and composite renal outcomes (HR 0.69), while GLP-1RA showed significant but more modest effects on these endpoints and greater benefits for atherosclerotic events and weight loss.

conclusionBoth SGLT2i and GLP-1RA are highly effective in reducing MACE in high-risk T2DM. Their markedly different secondary outcome profiles for heart failure, renal protection, atherosclerotic events, and weight loss underscore that they are complementary rather than interchangeable. The optimal choice should be individualized based on the patient's predominant comorbidities, treatment goals, and local access.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsIncretinsSodium-Glucose Transporter 2 InhibitorsAdultAgedFemaleGlucagon-Like Peptide-1 ReceptorHumansMaleMiddle AgedRandomized Controlled Trials as TopicRisk AssessmentTreatment OutcomeGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsIncretinsSodium-Glucose Transporter 2 InhibitorsGLP-1 receptor agonistsMajor adverse cardiovascular eventsMeta-analysisSGLT2 inhibitorsType 2 diabetes

Identifiers

PMID41454299
PMCPMC12849425

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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.