TY - JOUR
AR - JDMC-2020-2-103
TI - Comparative Retinopathy Risk in People with Type 2 Diabetes Treated with Post Metformin Second-line Incretin Therapies: Study Based on US Electronic Medical Records
AU - Sanjoy , Ketan Paul
AU - Jennie , Best
AU - Olga , Montvida
JO - Journal of Diabetes Metabolism and its Complications
PY - 2020
DA - Mon 19, Oct 2020
SN - 2674-4163
DO - http://dx.doi.org/10.31487/j.JDMC.2020.02.03
UR - https://www.sciencerepository.org/comparative-retinopathy-risk-in-people-with-type-2-diabetes-treated_JDMC-2020-2-103 
KW - Incretins, DPP-4 inhibitor, GLP-1 receptor agonist, retinopathy, microvascular disease, type 2 diabetes
AB - 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.