Table. Selected Baseline Characteristics of Unmatched and 1:1 Propensity Score–Matched Patients Initiating SGLT2 Inhibitor vs DPP-4 Inhibitor Therapy Overall and Stratified by HbA1c Levels.
| Characteristics before PS-matching | Subgroup HbA1c <7.5% | Subgroup HbA1c 7.5%-9% | Subgroup HbA1c >9% | Overall population | ||||||||
| SGLT2 inhibitor (n = 16 316) | DPP-4 inhibitor (n = 27 783) | St. Diff | SGLT2 inhibitor (n = 22 312) | DPP-4 inhibitor (n = 30 674) | St. Diff | SGLT2 inhibitor (n = 21 895) | DPP-4 inhibitor (n = 25 634) | St. Diff | SGLT2 inhibitor (n = 60 523) | DPP-4 inhibitor (n = 84 091) | St. Diff | |
| Age, mean (SD) | 61.1 (11.5) | 66.7 (11.6) | −0.5 | 60.8 (11.4) | 64.9 (11.9) | −0.4 | 56.7 (11.9) | 60.0 (13.0) | −0.3 | 59.4 (11.6) | 64.0 (12.1) | −0.4 |
| Male, No. (%) | 8466 (51.9) | 12 942 (46.6) | 0.1 | 12 554 (56.3) | 15 567 (50.7) | 0.1 | 12 782 (58.4) | 14 047 (54.8) | 0.1 | 33 802 (55.8) | 42 556 (50.6) | 0.1 |
| Female, No. (%) | 7850 (48.1) | 14 841 (53.4) | −0.1 | 9758 (43.7) | 15 107 (49.3) | −0.1 | 9113 (41.6) | 11 587 (45.2) | −0.1 | 26 721 (44.2) | 41 535 (49.4) | −0.1 |
| Race, No. (%) | ||||||||||||
| Asian | 1098 (6.7) | 2679 (9.6) | −0.1 | 1329 (6.0) | 2548 (8.3) | −0.1 | 991 (4.5) | 1545 (6.0) | −0.1 | 3418 (5.6) | 6772 (8.1) | −0.1 |
| Black | 1902 (11.7) | 3762(13.5) | −0.1 | 2495 (11.2) | 3851 (12.6) | −0.04 | 2946 (13.5) | 3859 (15.1) | −0.1 | 7343 (12.1) | 11 472 (13.6) | −0.04 |
| Hispanic | 3252 (19.9) | 6244 (22.5) | −0.1 | 4970 (22.3) | 7838 (25.6) | −0.1 | 5932 (27.1) | 7749 (30.2) | −0.1 | 14 154 (23.4) | 21 831 (26.0) | −0.1 |
| White | 9144 (56.0) | 13 584 (48.9) | 0.1 | 12 186 (54.6) | 14 686 (47.9) | 0.1 | 10 712 (48.9) | 11 060 (43.1) | 0.1 | 32 042 (52.9) | 39 330 (46.8) | 0.1 |
| Othera or unknown | 20 (5.6) | 1514 (5.4) | 0.01 | 1332 (6.0) | 1751 (5.7) | 0.01 | 1314 (6.0) | 1421 (5.5) | 0.02 | 3566 (5.9) | 4686 (5.6) | 0.01 |
| Obesity, No. (%) | 6254 (38.3) | 6889 (24.8) | 0.3 | 8107 (36.3) | 8178 (26.7) | 0.2 | 7952 (36.3) | 6932 (27.0) | 0.2 | 22 313 (36.9) | 21 999 (26.2) | 0.2 |
| Laboratory results, mean (SD) | ||||||||||||
| HbA1c value, %b | 6.8 (0.6) | 6.8 (0.6) | 0.1 | 8.2 (0.6) | 8.2 (0.6) | 0.1 | 10.6 (1.4) | 10.6 (1.5) | −0.01 | 8.7 (1.0) | 8.5 (1.0) | 0.3 |
| mmol/mol | 51 (NA) | 50 (NA) | NA | 66 (NA) | 66 (NA) | NA | 91 (NA) | 93 (NA) | NA | 72 (NA) | 69 (NA) | NA |
| eGFRCrc | 76.2 (23.9) | 68.0 (24.4) | 0.3 | 78.7 (23.4) | 73.4 (24.2) | 0.2 | 84.0 (24.5) | 80.1 (25.3) | 0.2 | 80.0 (23.9) | 73.7 (24.6) | 0.3 |
| Burden of comorbidities, mean (SD) | ||||||||||||
| Combined comorbidity scored | 1.1 (2.0) | 1.4 (2.3) | −0.2 | 1.0 (1.8) | 1.2 (2.0) | −0.1 | 1.0 (1.7) | 1.0 (1.9) | −0.03 | 1.0 (1.8) | 1.2 (2.1) | −0.1 |
| Frailty scoree | 0.2 (0.04) | 0.2 (0.1) | <0.01 | 0.1 (0.04) | 0.2 (0.04) | −0.3 | 0.1 (0.04) | 0.1 (0.04) | <0.01 | 0.1 (0.04) | 0.2 (0.04) | −0.3 |
| Diabetes-related comorbidities, No. (%) | ||||||||||||
| Diabetic nephropathy | 2353 (14.4) | 5948 (21.4) | −0.2 | 3350 (15.0) | 5884 (19.2) | −0.11 | 2830 (12.9) | 4019 (15.7) | −0.1 | 8533 (14.1) | 15 851 (18.8) | −0.13 |
| Diabetic retinopathy | 964 (5.9) | 1803 (6.5) | −0.02 | 1842 (8.3) | 2473 (8.1) | 0.01 | 1718 (7.8) | 1986 (7.7) | <0.01 | 4524 (7.5) | 6262 (7.4) | <0.01 |
| Lower-limb amputations | 66 (0.4) | 120 (0.4) | <0.01 | 104 (0.5) | 146 (0.5) | <0.01 | 145 (0.7) | 169 (0.7) | <0.01 | 315 (0.5) | 435 (0.5) | <0.01 |
| Diabetic ketoacidosis | 22 (0.1) | 35 (0.1) | <0.01 | 32 (0.1) | 42 (0.1) | <0.01 | 66 (0.3) | 78 (0.3) | <0.01 | 120 (0.2) | 155 (0.2) | <0.01 |
| Other comorbidities, No. (%) | ||||||||||||
| History of cardiovascular disease | 3873 (23.7) | 7194 (25.9) | −0.1 | 4783 (21.4) | 7110 (23.2) | −0.04 | 3953 (18.1) | 4636 (18.1) | <0.01 | 12 609 (20.8) | 18 940 (22.5) | −0.04 |
| Heart failure | 1284 (7.9) | 2378 (8.6) | −0.03 | 1325 (5.9) | 2093 (6.8) | −0.04 | 1402 (5.5) | 1633 (5.6) | <0.01 | 4011 (6.6) | 6104 (7.3) | −0.03 |
| Chronic kidney disease, stage <3 | 1156 (7.1) | 4930 (17.7) | −0.3 | 1333 (6.0) | 3868 (12.6) | −0.2 | 941 (4.3) | 2243 (8.8) | −0.2 | 3430 (5.7) | 11 041 (13.1) | −0.3 |
| Acute kidney injury | 368 (2.3) | 1235 (4.4) | −0.1 | 368 (1.6) | 841 (2.7) | −0.1 | 328 (1.5) | 596 (2.3) | −0.1 | 1064 (1.8) | 2672 (3.2) | −0.1 |
| Mycotic infections | 1389 (8.5) | 2638 (9.5) | −0.03 | 1857 (8.3) | 2912 (9.5) | −0.04 | 1986 (9.1) | 2440 (9.5) | −0.01 | 5232 (8.6) | 7990 (9.5) | −0.03 |
| Fractures | 138 (0.8) | 288 (1.0) | −0.02 | 144 (0.6) | 258 (0.8) | −0.02 | 144 (0.7) | 191 (0.7) | <0.01 | 426 (0.7) | 737 (0.9) | −0.02 |
| Falls | 353 (2.2) | 802 (2.9) | −0.04 | 441 (2.0) | 736 (2.4) | −0.03 | 437 (2.0) | 540 (2.1) | −0.01 | 1231 (2.0) | 2078 (2.5) | −0.03 |
| Diabetes treatment | ||||||||||||
| No use of any glucose-lowering drugs at baseline; No. (%) | 2610 (16.0) | 6053 (21.8) | −0.2 | 1898 (8.5) | 3843 (12.5) | −0.1 | 2584 (11.8) | 4630 (18.1) | −0.2 | 7092 (11.7) | 14 526 (17.3) | −0.2 |
| No. glucose-lowering drugs, mean (SD)f | 1.1 (0.9) | 1.0 (0.8) | 0.2 | 1.4 (0.9) | 1.2 (0.8) | 0.2 | 1.4 (0.9) | 1.3 (0.8) | 0.1 | 1.3 (0.9) | 1.2 (0.8) | <0.01 |
| Metformin, No. (%)f | 10 120 (62.0) | 16 545 (59.6) | 0.1 | 14 915 (66.8) | 20 337 (66.3) | 0.01 | 14 364 (65.6) | 17 562 (68.5) | −0.1 | 39 399 (65.1) | 54 444 (64.7) | 0.01 |
| Sulfonylureas (second generation), No. (%)f | 2863 (17.5) | 6334 (22.8) | −0.1 | 6756 (30.3) | 11 174 (36.4) | −0.1 | 6263 (28.6) | 9159 (35.7) | −0.2 | 15 882 (26.2) | 26 667 (31.7) | −0.1 |
| GLP-1 receptor agonists, No. (%)f | 2464 (15.1) | 580 (2.1) | 0.5 | 3637 (16.3) | 802 (2.6) | 0.5 | 3510 (16.0) | 806 (3.1) | 0.5 | 9611 (15.9) | 2188 (2.6) | 0.5 |
| Insulin, No. (%)f | 1750 (10.7) | 1536 (5.5) | 0.2 | 4226 (18.9) | 3405 (11.1) | 0.2 | 5433 (24.8) | 4476 (17.5) | 0.2 | 11 409 (18.9) | 9417 (11.2) | 0.2 |
| Characteristics after PS-matching | Subgroup HbA1c <7.5% | Subgroup HbA1c 7.5%-9% | Subgroup HbA1c >9% | Overall Population | ||||||||
| SGLT2 inhibitor (n = 12 026) | DPP-4 inhibitor (n = 12 026) | St. Diff | SGLT2 inhibitor (n = 16 145) | DPP-4 inhibitor (n = 16 145) | St. Diff | SGLT2 inhibitor (n = 15 466) | DPP-4 inhibitor (n = 15 466) | St. Diff | SGLT2 inhibitor (n = 43 637) | DPP-4 inhibitor (n = 43 637) | St. Diff | |
| Age, mean (SD) | 62.5 (11.4) | 62.3 (11.3) | 0.01 | 62.0 (11.5) | 62.0 (11.4) | 0.01 | 57.6 (12.2) | 57.7 (12.1) | −0.01 | 60.6 (11.7) | 60.6 (11.6) | <0.01 |
| Male, No. (%) | 6034 (50.2) | 6047 (50.3) | <0.01 | 8794 (54.5) | 8784 (54.4) | <0.01 | 8846 (57.2) | 8859 (57.3) | <0.01 | 23 674 (54.3) | 23 690 (54.3) | <0.01 |
| Female, No. (%) | 5992 (49.8) | 5979 (49.7) | <0.01 | 7351 (45.5) | 7361 (45.6) | <0.01 | 6620 (42.8) | 6607 (42.7) | <0.01 | 19 963 (45.7) | 19 947 (45.7) | <0.01 |
| Race, No. (%) | ||||||||||||
| Asian | 914 (7.6) | 906 (7.5) | <0.01 | 1092 (6.8) | 1113 (6.9) | <0.01 | 795 (5.1) | 785 (5.1) | <0.01 | 2801 (6.4) | 2804 (6.4) | <0.01 |
| Black | 1483 (12.3) | 1471 (12.2) | <0.01 | 1930 (12.0) | 1890 (11.7) | 0.01 | 2193 (14.2) | 2184 (14.1) | <0.01 | 5606 (12.8) | 5545 (12.7) | <0.01 |
| Hispanic | 2482 (20.6) | 2513 (20.9) | −0.01 | 3807 (23.6) | 3768 (23.3) | 0.01 | 4418 (28.6) | 4439 (28.7) | <0.01 | 10 707 (24.5) | 10 720 (24.6) | <0.01 |
| White | 6463 (53.7) | 6436 (53.5) | <0.01 | 8358 (51.8) | 8380 (51.9) | <0.01 | 7138 (46.2) | 7141 (46.2) | <0.01 | 21 959 (50.3) | 21 957 (50.3) | <0.01 |
| Othera or unknown | 684 (5.7) | 700 (5.8) | <0.01 | 958 (5.9) | 994 (6.2) | −0.01 | 922 (6.0) | 917 (5.9) | <0.01 | 2564 (5.9) | 2611 (6.0) | <0.01 |
| Obesity, No. (%) | 3995 (33.2) | 3959 (32.9) | 0.01 | 5198 (32.2) | 5209 (32.3) | <0.01 | 4941 (31.9) | 4922 (31.8) | <0.01 | 14 134 (32.4) | 14 090 (32.3) | <0.01 |
| Laboratory results, mean (SD) | ||||||||||||
| HbA1c value %b | 6.8 (0.6) | 6.8 (0.6) | 0.02 | 8.2 (0.6) | 8.2 (0.6) | <0.01 | 10.6 (1.4) | 10.6 (1.4) | <0.01 | 8.7 (1.0) | 8.7 (1.0) | <0.01 |
| mmol/mol | 51 (NA) | 51 (NA) | NA | 66 (NA) | 66 (NA) | NA | 93 (NA) | 93 (NA) | NA | 71 (NA) | 71 (NA) | NA |
| eGFRCrc | 74.9 (23.6) | 75.1 (23.6) | −0.01 | 77.4 (23.3) | 77.8 (23.5) | −0.02 | 83.2 (24.4) | 83.2 (24.5) | <0.01 | 78.8 (23.8) | 79.0 (23.9) | −0.01 |
| Burden of comorbidities, mean (SD) | ||||||||||||
| Combined comorbidity scored | 1.1 (2.0) | 1.1 (2.0) | <0.01 | 1.0 (1.9) | 1.0 (1.8) | 0.01 | 0.9 (1.7) | 0.9 (1.7) | 0.01 | 1.0 (1.9) | 1.0 (1.8) | 0.01 |
| Frailty indexe | 0.2 (0.04) | 0.2 (0.04) | <0.01 | 0.1 (0.04) | 0.1 (0.04) | <0.01 | 0.1 (0.04) | 0.1 (0.04) | <0.01 | 0.14 (0.04) | 0.14 (0.04) | <0.01 |
| Diabetes-related comorbidities, No. (%) | ||||||||||||
| Diabetic nephropathy | 1818 (15.1) | 1788 (14.9) | 0.01 | 2477 (15.3) | 2460 (15.2) | <0.01 | 2042 (13.2) | 2051 (13.3) | <0.01 | 6337 (14.5) | 6299 (14.4) | <0.01 |
| Diabetic retinopathy | 672 (5.6) | 677 (5.6) | <0.01 | 1267 (7.8) | 1261 (7.8) | <0.01 | 1134 (7.3) | 1139 (7.4) | <0.01 | 3073 (7.0) | 3077 (7.1) | <0.01 |
| Lower-limb amputations | 44 (0.4) | 40 (0.3) | 0.02 | 73 (0.5) | 76 (0.5) | <0.01 | 90 (0.6) | 94 (0.6) | <0.01 | 207 (0.5) | 210 (0.5) | <0.01 |
| Diabetic ketoacidosis | 14 (0.1) | 17 (0.1) | <0.01 | 21 (0.1) | 19 (0.1) | <0.01 | 43 (0.3) | 49 (0.3) | <0.01 | 78 (0.2) | 85 (0.2) | <0.01 |
| Other comorbidities, No. (%) | ||||||||||||
| History of cardiovascular disease | 2806 (23.3) | 2739 (22.8) | 0.01 | 3462 (21.4) | 3374 (20.9) | 0.01 | 2625 (17.0) | 2663 (17.2) | −0.01 | 8893 (20.4) | 8776 (20.1) | 0.01 |
| Heart failure | 874 (7.3) | 861 (7.2) | <0.01 | 951 (5.9) | 929 (5.8) | <0.01 | 767 (5.0) | 731 (4.7) | 0.01 | 2592 (5.9) | 2521 (5.8) | <0.01 |
| Chronic kidney disease, stage <3 | 1009 (8.4) | 974 (8.1) | 0.01 | 1158 (7.2) | 1121 (6.9) | 0.01 | 817 (5.3) | 777 (5.0) | 0.01 | 2984 (6.8) | 2872 (6.6) | 0.01 |
| Acute kidney injury | 286 (2.4) | 302 (2.5) | −0.01 | 289 (1.8) | 288 (1.8) | <0.01 | 254 (1.6) | 250 (1.6) | <0.01 | 829 (1.9) | 840 (1.9) | <0.01 |
| Mycotic infections | 1013 (8.4) | 975 (8.1) | 0.01 | 1365 (8.5) | 1383 (8.6) | <0.01 | 1418 (9.2) | 1421 (9.2) | <0.01 | 3796 (8.7) | 3779 (8.7) | <0.01 |
| Fractures | 105 (0.9) | 99 (0.8) | 0.01 | 111 (0.7) | 103 (0.6) | 0.01 | 108 (0.7) | 102 (0.7) | <0.01 | 324 (0.7) | 304 (0.7) | <0.01 |
| Falls | 272 (2.3) | 260 (2.2) | 0.01 | 341 (2.1) | 353 (2.2) | −0.01 | 306 (2.0) | 296 (1.9) | 0.01 | 919 (2.1) | 909 (2.1) | <0.01 |
| Diabetes treatment | ||||||||||||
| No use of any glucose-lowering drugs at baseline; No. (%) | 2266 (18.8) | 2276 (18.9) | <0.01 | 1699 (10.5) | 1687 (10.4) | <0.01 | 2308 (14.9) | 2290 (14.8) | <0.01 | 6273 (14.4) | 6253 (14.3) | <0.01 |
| No. glucose-lowering drugs, mean (SD)f | 1.0 (0.8) | 1.0 (0.8) | <0.01 | 1.3 (0.9) | 1.3 (0.8) | 0.01 | 1.3 (0.9) | 1.3 (0.8) | −0.01 | 1.2 (0.9) | 1.2 (0.8) | <0.01 |
| Metformin, No. (%)f | 7400 (61.5) | 7573 (63.0) | −0.03 | 10 788 (66.8) | 11 062 (68.5) | −0.04 | 10 360 (67.0) | 10 584 (68.4) | −0.03 | 28 548 (65.4) | 29 219 (67.0) | −0.03 |
| Sulfonylureas (second generation), No. (%)f | 2280 (19.0) | 2311 (19.2) | −0.01 | 5269 (32.6) | 5300 (32.8) | <0.01 | 4937 (31.9) | 4937 (31.9) | <0.01 | 12 486 (28.6) | 12 548 (28.8) | <0.01 |
| GLP-1 receptor agonists, No. (%)f | 754 (6.3) | 537 (4.5) | 0.1 | 1024 (6.3) | 760 (4.7) | 0.1 | 976 (6.3) | 772 (5.0) | 0.1 | 2754 (6.3) | 2069 (4.7) | 0.1 |
| Insulin, No. (%)f | 939 (7.8) | 838 (7.0) | 0.03 | 2268 (14.0) | 2199 (13.6) | 0.01 | 3109 (20.1) | 3086 (20.0) | <0.01 | 6316 (14.5) | 6123 (14.0) | 0.01 |
Abbreviations: DPP-4i, dipeptidyl peptidase 4 inhibitors; eGFRCr, creatinine-based estimated glomerular filtration rate; GLP-1, glucagon-like peptide-1; HbA1c, hemoglobin A1c; NA, not applicable; PS, propensity score; SGLT2, sodium-glucose cotransporter-2; St. Diff, standardized differences, ie, the difference in means or proportions divided by the pooled.
a
American Indian, Alaska Native, Native Hawaiian, or other Pacific Islander.
b
To convert to proportion of total hemoglobin, multiply by 0.01.
c
eGFRCr has been estimated applying the creatinine-based Chronic Kidney Disease–Epidemiology Collaboration (CKD-EPI) equation with no inclusion of race as correction factor.
d
A higher combined comorbidity score is associated with a greater risk of mortality during the follow-up.
e
Individuals are considered prefrail when the frailty index is between 0.15 and 0.24 and frail when the frailty index is at least 0.25.
f
Treatment prescriptions overlapping the date of initiation of the study drugs (ie, concurrent use).