Evidence map›Paper›PMID 41857198›Full record

ArticleNature medicine2026

Glucagon-like peptide-1 receptor agonists for major cardiovascular and kidney outcomes in type 1 diabetes.

Yunwen Xu, Natalie Daya Malek, Alexander R Chang, Justin B Echouffo-Tcheugui, Elizabeth Selvin, Morgan E Grams, Michael Fang, Jung-Im Shin

Abstract read
In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Article
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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

8 authors.

Yunwen XuDepartment of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Natalie Daya MalekDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Alexander R ChangDepartments of Nephrology and Population Health Sciences, Geisinger Health, Danville, PA, USA.
Justin B Echouffo-TcheuguiDivision of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Elizabeth SelvinDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-3539-2070
Morgan E GramsDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-4430-6023
Michael FangDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-2849-1780
Jung-Im ShinDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jshin19@jhmi.edu.ORCID http://orcid.org/0000-0003-0374-6927

Funding

Medication Use and Adverse Events in CKDR01DK115534 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Alexander R Chang, Morgan Erika Grams · 2018 to 2026
$5.7M
Challenges to Guideline-Recommended Diabetes Care in the United StatesR01DK139324 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Jung-Im Shin · 2025 to 2026
$1.4M
Prevention and Treatment of Cardiovascular Disease in Patients with Chronic Kidney Disease: Patient-Oriented Research and Mentoring - RenewalK24HL155861 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Morgan Erika Grams · 2021 to 2026
$732k
Research and Mentoring in the Clinical Epidemiology of Cardiovascular Disease and Type 2 DiabetesK24HL152440 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2020 to 2024
$612k
Disparities in the management and prognosis of type 1 diabetesK01DK138273 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Michael Fang · 2024 to 2026
$470k
NHLBI NIH HHS K24 HL152440NHLBI NIH HHS K24 HL155861NIDDK NIH HHS K01 DK138273NIDDK NIH HHS R01 DK115534NIDDK NIH HHS R01 DK139324
6 · The paper itself

Abstract

There is substantial interest in the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in type 1 diabetes, but data on the long-term clinical outcomes are lacking. Using national electronic health record data from 174,678 patients with type 1 diabetes, we conducted a sequential target trial emulation from January 2013 to March 2024. After propensity score weighting, GLP-1RA initiation was associated with significantly lower risks of major adverse cardiovascular events (5-year risk: 4.3% versus 5.0%; risk difference: -0.7% (95% confidence interval (CI): -1.2% to -0.2%); hazard ratio (HR): 0.85 (0.77-0.95)) and end-stage kidney disease (5-year risk: 1.6% versus 1.9%; risk difference: -0.3% (-0.6% to 0%); HR: 0.81 (0.69-0.95)). No increased risks of hospitalization for diabetic ketoacidosis or severe hypoglycemia were observed. These findings suggest that GLP-1RAs may be beneficial against major adverse cardiorenal events in patients with type 1 diabetes, without compromising safety.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 1Glucagon-Like Peptide-1 Receptor AgonistsKidney Failure, ChronicAdolescentAdultAgedDiabetic KetoacidosisElectronic Health RecordsFemaleFollow-Up StudiesHumansHypoglycemiaLongitudinal StudiesMaleMiddle AgedGlucagon-Like Peptide-1 Receptor Agonists

Identifiers

PMID41857198
PMCPMC13190255

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.