{"doi":"10.1111/dom.16207","title":"Comparative effectiveness of insulin glargine, glucagon‐like peptide‐1 receptor agonists and <scp>sodium‐glucose cotransporter‐2 inhibitors</scp> in veterans with type 2 diabetes","abstract":"AIMS: To compare the risk of all-cause death and cardiovascular events in new users of insulin glargine, glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), particularly in subgroups defined by baseline haemoglobin A1C (HbA1C), body mass index (BMI) and estimated glomerular filtration rate (eGFR). MATERIALS AND METHODS: We conducted an active comparator, new user design study in a national cohort of 161 405 veterans with type 2 diabetes (T2D) on metformin and initiated insulin glargine (n = 54 375), GLP-1RA (n = 22 145) or SGLT2i (n = 84 885) between 1 January 2018 and 31 December 2021. Patients were followed until 31 March 2023. Inverse probability weighted Cox regression models were used for treatment comparisons on all-cause deaths and cardiovascular events in the entire cohort and above subgroups. RESULTS: There were 20 788 cardiovascular events/414 414 person-years and 15 268 all-cause deaths/446 458 person-years. Insulin glargine had a higher hazard of all-cause death compared to GLP-1RA (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.48-1.67) or SGLT2i (HR 1.55, 95% CI 1.48-1.61) in the entire cohort and across subgroups, especially in those with HbA1C levels <9.0%. Results were similar for secondary outcomes. Compared to GLP-1RA, SGLT2i had similar risk of all-cause death (HR 1.03, 95% CI 0.97-1.10) but higher hazard of cardiovascular events (HR 1.13, 95% CI 1.08-1.19). Across subgroups, GLP-1RA and SGLT2i had generally similar effects, with SGLT2i showing a slightly higher risk in some cases. CONCLUSIONS: Insulin glargine might be deleterious particularly in those with HbA1C <9.0%. There was no clear evidence for prioritization of SGLT2i versus GLP-1RA across subgroups.","journal":"Diabetes Obesity and Metabolism","year":2025,"id":550100,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9615,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1445431,"name":"Amara Sarwal","orcid":null,"position":1,"is_corresponding":false},{"id":1444692,"name":"Ravinder Singh","orcid":"0000-0002-7221-8557","position":2,"is_corresponding":false},{"id":1444693,"name":"Sydney E. Hartsell","orcid":"0000-0001-7328-3732","position":3,"is_corresponding":false},{"id":513024,"name":"Guo Wei","orcid":"0000-0002-4971-8430","position":4,"is_corresponding":false},{"id":518379,"name":"McKenna Nevers","orcid":null,"position":5,"is_corresponding":false},{"id":342383,"name":"Jesse C. Christensen","orcid":"0000-0003-1444-203X","position":6,"is_corresponding":false},{"id":1445432,"name":"Augustine Takyi","orcid":null,"position":7,"is_corresponding":false},{"id":1445433,"name":"Niharika Katkam","orcid":null,"position":8,"is_corresponding":false},{"id":546087,"name":"Catherine G. Derington","orcid":"0000-0001-7382-4607","position":9,"is_corresponding":false},{"id":777190,"name":"Vikrant Deshmukh","orcid":"0000-0001-6670-8245","position":10,"is_corresponding":false},{"id":513025,"name":"Robert E. Boucher","orcid":"0000-0002-5455-002X","position":11,"is_corresponding":false},{"id":232416,"name":"Stavros G. Drakos","orcid":"0000-0002-1223-327X","position":12,"is_corresponding":false},{"id":58433,"name":"Tom Greene","orcid":"0000-0002-3706-7570","position":13,"is_corresponding":false},{"id":295961,"name":"Srinivasan Beddhu","orcid":"0000-0002-3312-315X","position":14,"is_corresponding":false},{"id":557938,"name":"Jincheng Shen","orcid":"0000-0002-6551-3558","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:54:12.321988Z","pmid":"39887855","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}