SGLT2 inhibitors protective against retinopathy in type 2 diabetes

In a study published in JAMA Network Open, Taiwanese researchers analyzed the risk of developing sight-threatening diabetic retinopathy in type 2 diabetes patients taking sodium-glucose cotransporter 2 (SGLT2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, pioglitazone, or sulfonylurea. They found that SGLT2 inhibitors are associated with a lower risk for sight-threatening retinopathy than other second-line glucose-lowering medications in patients with type 2 diabetes. Specifically, they found that SGLT2 inhibitors reduced sight-threatening retinopathy risk by 43% vs DPP-4 inhibitors, 38% vs sulfonylurea, and 25% vs pioglitazone. Similarly, the cumulative incidence of sight-threatening retinopathy was significantly lower with SGLT2 inhibitors vs DPP-4i, pioglitazone, or sulfonylurea. All three SGLT2 inhibitor treatments studied, namely empagliflozin, dapagliflozin, and canagliflozin, were more effective than DPP-4 inhibitors, pioglitazone, or sulfonylurea in reducing the risk for sight-threatening retinopathy. “SGLT2i treatments were as safe and effective in slowing the progression of diabetic retinopathy as in lowering the risk for diabetic nephropathy in patients with T2D,” the authors commented.

There were, however, several limitations to the study. There were insufficient data regarding the participants’ alcohol use, physical activity, smoking status, and family history, which may have had an impact on the results. In addition, the study mainly involved individuals of Taiwanese ethnicity.

Source: Shrabasti Bhattacharya, Medscape Medical News, January 23, 2024; see source article