Comparative Retinopathy Risk in People with Type 2 Diabetes Treated with Post Metformin Second-line Incretin Therapies: Study Based on US Electronic Medical Records

Author Info

Sanjoy Ketan Paul Jennie Best Olga Montvida

Corresponding Author

Sanjoy Ketan Paul
Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, Australia

A B S T R A C T

Studies have reported conflicting results of the association of incretin-based treatment with the risk of diabetic retinopathy (DR), while the risk of DR in people treated with different antidiabetic drugs (ADD) in the context of glycaemic control in real-world settings is limited. This study aimed to evaluate (1) the risk of developing DR in metformin-treated patients with type 2 diabetes (T2DM) who initiated secondline ADD and (2) if glycaemic control over one-year post-therapy initiation is associated with DR risk during follow-up . From US Electronic Medical Records (EMR), those who received second line DPP-4 inhibitor (DPP-4i), GLP-1 receptor agonist (GLP-1RA), sulfonylurea, thiazolidinedione, or insulin for ≥3 months post-2004 were analysed. Based on 237,133 people with an average of 3.2 years follow-up, compared to people who initiated second-line with sulfonylurea, those with DPP-4i/GLP1RA/thiazolidinedione had 30%/31%/15% significantly lower adjusted risk of developing DR; insulin users had 84% increased risk (all p< 0.01), with significantly better sustainable HbA1c control over one year in incretin groups. This population representative EMR based study suggests that DR risk is not higher in people treated with incretins, versus other ADD, with the benefit of better glycaemic control.

Article Info

Article Type

Research Article

Publication history

Received: Wed 23, Sep 2020
Accepted: Thu 08, Oct 2020
Published: Mon 19, Oct 2020

Copyright

© 2023 Sanjoy Ketan Paul. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JDMC.2020.02.03