Evidence map›Paper›PMID 36872060›Full record

ArticleDiabetes & metabolism journal2023

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists.

Tzu-Yi Lin, Eugene Yu-Chuan Kang, Shih-Chieh Shao, Edward Chia-Cheng Lai, Sunir J Garg, Kuan-Jen Chen, Je-Ho Kang, Wei-Chi Wu, Chi-Chun Lai, Yih-Shiou Hwang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes & metabolism journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
7.6field-weighted citation impact, top 2% of its field
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

25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
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  4. Glucagon-like peptide-1 receptor agonists and diabetic retinopathy: a systematic review of diabetic retinopathy outcomes.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Review
  5. Retinal and optic nerve measures after initiation of empagliflozin plus metformin versus metformin alone in early type 2 diabetes: a prospective observational comparative study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
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  11. Semaglutide and diabetic retinopathy: an OHDSI network study.BMJ open diabetes research & care · 2025 · on this map
    Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Tzu-Yi LinDepartment of Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Eugene Yu-Chuan KangCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Shih-Chieh ShaoDepartment of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Edward Chia-Cheng LaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Sunir J GargMidAtlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
Kuan-Jen ChenCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Je-Ho KangDepartment of Nephrology, Yang Ming Hospital, Taoyuan, Taiwan.
Wei-Chi WuCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chi-Chun LaiCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Yih-Shiou HwangCollege of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chang Gung University · TWKeelung Chang Gung Memorial Hospital · TWMin Sheng General Hospital · TWNational Cheng Kung University · TWThomas Jefferson University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.

methodsThis retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.

resultsThere were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).

conclusionCompared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathySodium-Glucose Transporter 2 InhibitorsAdultGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsGlucoseHumansHypoglycemic AgentsRetrospective StudiesSodiumGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsGlucoseHypoglycemic AgentsSodiumSodium-Glucose Transporter 2 InhibitorsDiabetic retinopathyGlucagon-like peptide-1 receptorRetrospective studiesSodium-glucose transporter 2 inhibitors

Identifiers

PMID36872060
PMCPMC10244193
OpenAlexW4323270712

What OpenQuestion holds

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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 OpenQuestion graph.