Table 1.
Selected baseline characteristics of patients initiating SGLT2i versus GLP-1RA before and after 1:1 PS matching
| Baseline characteristics | Before PS matching | After PS matching | ||||
|---|---|---|---|---|---|---|
| SGLT2i (N = 72,900) | GLP-1RA (N = 64,417) | St. Diff. | SGLT2i (N = 45,047)∗ | GLP-1RA (N = 45,047)∗ | St. Diff. | |
| Demographics | ||||||
| Age, mean (SD) | 71.98 (5.28) | 71.43 (4.94) | 0.11 | 71.56 (5.01) | 71.56 (5.03) | 0.00 |
| Male, n (%) | 35,982 (49.4) | 28,044 (43.5) | 0.12 | 20,541 (45.6) | 20,720 (46.0) | −0.01 |
| Race/ethnicity, n (%) | ||||||
| White | 58,251 (79.9) | 54,125 (84.0) | −0.11 | 37,588 (83.4) | 37,520 (83.3) | 0.00 |
| Black | 5,281 (7.2) | 4,997 (7.8) | −0.02 | 3,396 (7.5) | 3,388 (7.5) | 0.00 |
| Asian | 3,434 (4.7) | 1,433 (2.2) | 0.14 | 1,138 (2.5) | 1,177 (2.6) | −0.01 |
| Hispanic | 2,601 (3.6) | 1,719 (2.7) | 0.05 | 1,284 (2.9) | 1,300 (2.9) | 0.00 |
| Other | 3,333 (4.6) | 2,143 (3.3) | 0.06 | 1,641 (3.6) | 1,662 (3.7) | −0.01 |
| Burden of comorbidities, mean (SD) | ||||||
| Combined Comorbidity Score† | 2.94 (2.03) | 3.45 (2.32) | −0.23 | 3.16 (2.15) | 3.17 (2.15) | 0.00 |
| Frailty score (29) | 0.18 (0.06) | 0.19 (0.06) | −0.17 | 0.19 (0.06) | 0.19 (0.06) | 0.00 |
| Diabetes-related conditions, n (%) | ||||||
| Diabetic nephropathy | 6,614 (9.1) | 9,850 (15.3) | −0.19 | 5,132 (11.4) | 5,122 (11.4) | 0.00 |
| Diabetic retinopathy | 7,664 (10.5) | 7,888 (12.2) | −0.05 | 4,966 (11.0) | 4,958 (11.0) | 0.00 |
| Diabetic neuropathy | 17,187 (23.6) | 18,251 (28.3) | −0.11 | 11,721 (26.0) | 11,709 (26.0) | 0.00 |
| Diabetes with peripheral circulatory disorders | 5,841 (8.0) | 5,689 (8.8) | −0.03 | 3,708 (8.2) | 3,783 (8.4) | −0.01 |
| Diabetic foot | 1,897 (2.6) | 2,329 (3.6) | −0.06 | 1,378 (3.1) | 1,393 (3.1) | 0.00 |
| Lower-extremity amputation | 264 (0.4) | 355 (0.6) | −0.03 | 210 (0.5) | 204 (0.5) | 0.00 |
| Hypoglycemia | 3,529 (4.8) | 3,725 (5.8) | −0.04 | 2,303 (5.1) | 2,330 (5.2) | 0.00 |
| DKA | 244 (0.3) | 298 (0.5) | −0.03 | 157 (0.3) | 182 (0.4) | −0.02 |
| Diabetes treatment | ||||||
| No. of antidiabetes drugs at cohort entry, mean (SD) | 2.65 (1.00) | 2.49 (0.98) | 0.16 | 2.54 (0.98) | 2.53 (0.99) | 0.01 |
| No previous use of diabetes treatment, n (%)¶ | 2,609 (3.6) | 2,954 (4.6) | −0.05 | 1,957 (4.3) | 1,939 (4.3) | 0.00 |
| Monotherapy, n (%) | 2,332 (3.2) | 2,663 (4.1) | −0.05 | 1,768 (3.9) | 1,752 (3.9) | 0.00 |
| Long-term use of insulin, n (%)§ | 5,969 (8.2) | 9,620 (14.9) | −0.21 | 5,201 (11.5) | 5,257 (11.7) | −0.01 |
| Diabetes drug on the day of entry to the cohort, n (%) | ||||||
| Metformin | 46,049 (63.2) | 34,419 (53.4) | 0.20 | 26,190 (58.1) | 26,086 (57.9) | 0.00 |
| Sulfonylureas | 29,266 (40.1) | 23,039 (35.8) | 0.09 | 16,839 (37.4) | 16,725 (37.1) | 0.01 |
| DPP-4 inhibitors | 24,783 (34.0) | 13,425 (20.8) | 0.30 | 10,923 (24.2) | 11,004 (24.4) | 0.00 |
| Glitazones | 5,846 (8.0) | 4,853 (7.5) | 0.02 | 3,491 (7.7) | 3,518 (7.8) | 0.00 |
| Insulin | 12,742 (17.5) | 18,853 (29.3) | −0.28 | 10,847 (24.1) | 10,741 (23.8) | 0.01 |
| Lifestyle factors, n (%) | ||||||
| Obesity | 17,621 (24.2) | 21,980 (34.1) | −0.22 | 13,436 (29.8) | 13,414 (29.8) | 0.00 |
| Overweight | 3,812 (5.2) | 2,822 (4.4) | 0.04 | 2,111 (4.7) | 2,124 (4.7) | 0.00 |
| Smoking | 11,579 (15.9) | 11,207 (17.4) | −0.04 | 7,721 (17.1) | 7,692 (17.1) | 0.00 |
| Other comorbidities at baseline, n (%) | 0.00 | |||||
| CVD‖ | 31,888 (43.7) | 30,563 (47.4) | −0.07 | 20,366 (45.2) | 20,385 (45.3) | 0.00 |
| Ischemic heart disease | 23,018 (31.6) | 22,084 (34.3) | −0.06 | 14,763 (32.8) | 14,729 (32.7) | 0.00 |
| Acute myocardial infarction | 1,126 (1.5) | 1,098 (1.7) | −0.02 | 712 (1.6) | 740 (1.6) | 0.00 |
| Coronary revascularization | 587 (0.8) | 650 (1.0) | −0.02 | 395 (0.9) | 403 (0.9) | 0.00 |
| Heart failure | 7,082 (9.7) | 8,801 (13.7) | −0.12 | 5,144 (11.4) | 5,170 (11.5) | 0.00 |
| Atrial fibrillation | 7,353 (10.1) | 7,398 (11.5) | −0.05 | 4,861 (10.8) | 4,911 (10.9) | 0.00 |
| Ischemic or hemorrhagic stroke | 8,145 (11.2) | 7,549 (11.7) | −0.02 | 5,138 (11.4) | 5,114 (11.4) | 0.00 |
| Transient ischemic attack | 1,787 (2.5) | 1,666 (2.6) | −0.01 | 1,138 (2.5) | 1,163 (2.6) | −0.01 |
| Peripheral arterial disease or surgery | 9,041 (12.4) | 8,811 (13.7) | −0.04 | 5,736 (12.7) | 5,808 (12.9) | −0.01 |
| Hypertension | 66,311 (91.0) | 59,585 (92.5) | −0.05 | 41,326 (91.7) | 41,323 (91.7) | 0.00 |
| Hyperlipidemia | 65,426 (89.7) | 58,092 (90.2) | −0.02 | 40,488 (89.9) | 40,413 (89.7) | 0.01 |
| Chronic obstructive pulmonary disease | 8,524 (11.7) | 9,187 (14.3) | −0.08 | 5,848 (13.0) | 5,883 (13.1) | 0.00 |
| Pneumonia | 2,614 (3.6) | 2,902 (4.5) | −0.05 | 1,823 (4.0) | 1,824 (4.0) | 0.00 |
| Obstructive sleep apnea | 8,084 (11.1) | 10,876 (16.9) | −0.17 | 6,416 (14.2) | 6,453 (14.3) | 0.00 |
| Osteoarthritis | 21,613 (29.6) | 21,292 (33.1) | −0.08 | 14,256 (31.6) | 14,227 (31.6) | 0.00 |
| Chronic kidney disease | 9,037 (12.4) | 14,729 (22.9) | −0.28 | 7,294 (16.2) | 7,437 (16.5) | −0.01 |
| Chronic kidney disease, stage 3+ | 5,303 (7.3) | 10,773 (16.7) | −0.29 | 4,753 (10.6) | 4,784 (10.6) | 0.00 |
| AKI | 1,994 (2.7) | 3,281 (5.1) | −0.12 | 1,603 (3.6) | 1,636 (3.6) | 0.00 |
| Edema‡ | 8,391 (11.5) | 10,311 (16.0) | −0.13 | 6,160 (13.7) | 6,140 (13.6) | 0.00 |
| Fractures | 3,275 (4.5) | 3,369 (5.2) | −0.03 | 2,254 (5.0) | 2,233 (5.0) | 0.00 |
| Falls | 3,067 (4.2) | 3,246 (5.0) | −0.04 | 2,135 (4.7) | 2,110 (4.7) | 0.00 |
| Osteoporosis | 7,303 (10.0) | 6,151 (9.5) | 0.02 | 4,240 (9.4) | 4,248 (9.4) | 0.00 |
| Genital infections | 2,223 (3.0) | 2,128 (3.3) | −0.02 | 1,452 (3.2) | 1,477 (3.3) | −0.01 |
| UTIs | 11,375 (15.6) | 12,191 (18.9) | −0.09 | 7,780 (17.3) | 7,723 (17.1) | 0.01 |
| Dementia | 3,341 (4.6) | 2,987 (4.6) | 0.00 | 2,088 (4.6) | 2,025 (4.5) | 0.00 |
| Other medication use, n (%) | ||||||
| ACE inhibitors | 33,901 (46.5) | 30,726 (47.7) | −0.02 | 21,199 (47.1) | 21,233 (47.1) | 0.00 |
| Angiotensin II receptor blockers | 27,012 (37.1) | 24,298 (37.7) | −0.01 | 16,850 (37.4) | 16,789 (37.3) | 0.00 |
| β-Blockers | 34,537 (47.4) | 32,856 (51.0) | −0.07 | 22,216 (49.3) | 22,153 (49.2) | 0.00 |
| Calcium channel blockers | 24,372 (33.4) | 22,530 (35.0) | −0.03 | 15,368 (34.1) | 15,335 (34.0) | 0.00 |
| Thiazides | 10,890 (14.9) | 11,390 (17.7) | −0.08 | 7,439 (16.5) | 7,463 (16.6) | 0.00 |
| Loop diuretics | 12,008 (16.5) | 16,050 (24.9) | −0.21 | 9,146 (20.3) | 9,241 (20.5) | 0.00 |
| Other diuretics | 2,532 (3.5) | 3,496 (5.4) | −0.09 | 1,970 (4.4) | 2,024 (4.5) | 0.00 |
| Nitrates | 6,163 (8.5) | 6,430 (10.0) | −0.05 | 4,053 (9.0) | 4,145 (9.2) | −0.01 |
| Digoxin | 2,027 (2.8) | 1,768 (2.7) | 0.01 | 1,214 (2.7) | 1,206 (2.7) | 0.00 |
| Statins | 56,268 (77.2) | 50,333 (78.1) | −0.02 | 34,874 (77.4) | 34,877 (77.4) | 0.00 |
| Antiplatelets | 12,197 (16.7) | 11,104 (17.2) | −0.01 | 7,476 (16.6) | 7,542 (16.7) | 0.00 |
| Anticoagulants | 6,063 (8.3) | 6,399 (9.9) | −0.06 | 4,137 (9.2) | 4,159 (9.2) | 0.00 |
| Oral corticosteroids | 19,502 (26.8) | 18,269 (28.4) | −0.04 | 12,463 (27.7) | 12,434 (27.6) | 0.00 |
| Bisphosphonates | 2,971 (4.1) | 2,267 (3.5) | 0.03 | 1,589 (3.5) | 1,586 (3.5) | 0.00 |
| Antibiotics targeting UTIs | 20,633 (28.3) | 20,628 (32.0) | −0.08 | 13,699 (30.4) | 13,711 (30.4) | 0.00 |
| Opioids | 23,530 (32.3) | 25,056 (38.9) | −0.14 | 16,301 (36.2) | 16,305 (36.2) | 0.00 |
| Benzodiazepines | 10,203 (14.0) | 9,803 (15.2) | −0.03 | 6,746 (15.0) | 6,747 (15.0) | 0.00 |
| Measures of health care use | ||||||
| Hospitalization within prior 30 days, n (%) | 717 (1.0) | 812 (1.3) | −0.03 | 501 (1.1) | 491 (1.1) | 0.00 |
| Hospitalization during prior 31–365 days, n (%) | 6,842 (9.4) | 7,762 (12.0) | −0.08 | 4,771 (10.6) | 4,768 (10.6) | 0.00 |
| No. of hospital days, mean (SD) | 0.67 (3.05) | 0.91 (3.60) | −0.07 | 0.77 (3.37) | 0.78 (3.43) | 0.00 |
| No. of emergency department visits, mean (SD) | 0.71 (1.78) | 0.86 (1.94) | −0.08 | 0.79 (1.85) | 0.79 (1.86) | 0.00 |
| No. of office visits, mean (SD) | 10.72 (7.60) | 12.16 (8.36) | −0.18 | 11.36 (7.90) | 11.36 (7.75) | 0.00 |
| Endocrinologist visit within prior 30 days, n (%) | 8,789 (12.1) | 11,963 (18.6) | −0.18 | 6,840 (15.2) | 6,829 (15.2) | 0.00 |
| Endocrinologist visit during prior 31–365 days, n (%) | 10,873 (14.9) | 12,883 (20.0) | −0.13 | 7,891 (17.5) | 7,875 (17.5) | 0.00 |
| Cardiologist visit within prior 30 days, n (%) | 7,051 (9.7) | 6,869 (10.7) | −0.03 | 4,486 (10.0) | 4,563 (10.1) | 0.00 |
| Cardiologist visit during prior 31–365 days, n (%) | 27,931 (38.3) | 27,491 (42.7) | −0.09 | 18,155 (40.3) | 18,210 (40.4) | 0.00 |
| No. of electrocardiograms, mean (SD) | 1.13 (1.91) | 1.27 (2.11) | −0.07 | 1.19 (1.98) | 1.19 (2.03) | 0.00 |
| Echocardiogram, n (%) | 15,297 (21.0) | 15,410 (23.9) | −0.07 | 9,995 (22.2) | 10,044 (22.3) | 0.00 |
| Number of distinct prescriptions, mean (SD) | 13.35 (6.03) | 14.73 (6.25) | −0.22 | 14.04 (6.24) | 14.04 (5.94) | 0.00 |
| No. of HbA1c tests ordered, mean (SD) | 2.81 (1.36) | 2.89 (1.42) | −0.06 | 2.85 (1.37) | 2.84 (1.37) | 0.01 |
DPP-4, dipeptidyl peptidase 4; HbA1c, hemoglobin A1c; St. Diff, standardized differences, i.e., the difference in means or proportions divided by the pooled SD (30).
*
Canagliflozin, 76.9%; dapagliflozin, 13.1%; empagliflozin, 11.1%; liraglutide, 58.7%; exenatide, 23.5%; dulaglutide, 14.8%; albiglutide, 3.0%.
†
Gagne et al. (32).
¶
Defined as patients without any use of glucose-lowering medications during the 12 months prior to cohort entry.
§
Based on ICD coding.
‖
Defined as history of myocardial infarction, unstable angina, coronary atherosclerosis and other forms of chronic ischemic heart disease, coronary procedure, heart failure, ischemic or hemorrhagic stroke, transient ischemic attack, peripheral arterial disease or surgery, or lower-extremity amputation.
‡
Localized, generalized, or unspecified edema.