Evidence map›Paper›PMID 42608294›Full record

ArticleDiabetes, obesity & metabolism2026

Hospitalisation Is a Strong Risk Factor for Discontinuation of Sodium-Glucose Cotransporter 2 Inhibitors for Type 2 Diabetes.

Tamara Y Milder, Leah Shepherd, Hans Kristian Raket, Jerry R Greenfield, Richard O Day, Jialing Lin, Juliana de Oliveira Costa, Sophie Stocker, Carol A Pollock, Brendon Neuen and 4 more

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In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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.

Tamara Y MilderMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0009-0002-0538-2661
Leah ShepherdMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.
Hans Kristian RaketMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0009-0005-7959-1548
Jerry R GreenfieldSchool of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, University of New South Wales, Sydney, Australia.
Richard O DaySchool of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0002-6045-6937
Jialing LinInternational Centre for Future Health Systems, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0002-0643-9191
Juliana de Oliveira CostaMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.
Sophie StockerSchool of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, University of New South Wales, Sydney, Australia.
Carol A PollockFaculty of Medicine and Health, The University of Sydney, Australia.
Brendon NeuenFaculty of Medicine and Health, The University of Sydney, Australia.ORCID https://orcid.org/0000-0001-9276-8380
Min JunThe George Institute for Global Health, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0003-1460-7535
Jane LudingtonDepartment of Endocrinology, St Vincent's Hospital, Sydney, Australia.
Sallie-Anne PearsonMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.
Michael O FalsterMedicines Intelligence Research Program, School of Population Health, University of New South Wales, Sydney, Australia.ORCID https://orcid.org/0000-0001-6444-7272

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly withheld during hospitalisation because of concerns about diabetic ketoacidosis. We examined whether hospitalisation was associated with discontinuation of SGLT2i and compared patterns with another anti-hyperglycaemic medicine without similar inpatient safety concerns: dipeptidyl peptidase-4 inhibitors (DPP-4i). MATERIALS AND

methodsWe conducted a retrospective new-user cohort study using linked, population-level data for adult residents of New South Wales, Australia. Adults aged ≥ 40 years initiating SGLT2i or DPP-4i (separate cohorts) between 2016 and 2020 were followed until death, mid-2021, or treatment discontinuation (gap of ≥ 90 days without a dispensing of the index medicine). We used Cox proportional hazards models to estimate the association between hospitalisation and discontinuation, adjusting for demographic and clinical characteristics. We treated the 'hospitalisation period' (the inpatient stay plus the 90 days following discharge) as a time-dependent exposure.

resultsAmong people initiating SGLT2i (n = 106 098), the median age was 63 years and 61% were male. Overall, 35.1% were hospitalised during follow-up, and discontinuation was substantially more frequent during the hospitalisation period (56.4 per 100 person-years) compared with other follow-up times (37.6 per 100 person-years). This association remained significant after adjustment (HR: 1.83; 95% CI: 1.79-1.87). Similar patterns were observed among DPP-4i treated people (HR: 1.55; 95% CI: 1.51-1.58).

conclusionsHospitalisation is a strong risk factor for discontinuation of SGLT2i and DPP-4i therapy. Strategies to support re-initiation of SGLT2i during transitions from hospital to community care are needed to prevent harm and maximise cardiorenal protective effects of these medicines.

Indexed as

Diabetes Mellitus, Type 2HospitalizationHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsAdultAgedDiabetic KetoacidosisDipeptidyl-Peptidase IV InhibitorsFemaleHumansMaleMiddle AgedNew South WalesRetrospective StudiesRisk FactorsDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsDPP‐IV inhibitorpharmaco‐epidemiologyreal‐world evidenceSGLT2 inhibitortype 2 diabetes

Identifiers

PMID42608294
PMCPMC13646384

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.