Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;38(8):108808.
doi: 10.1016/j.jdiacomp.2024.108808. Epub 2024 Jul 14.

Dipeptidyl peptidase 4 inhibitors, sodium glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists do not worsen diabetic macular edema

Alexander Phu  1 , Mark Banghart  2 , Mozhdeh Bahrainian  2 , T Y Alvin Liu  3 , Risa M Wolf  4 , Roomasa Channa  5
Affiliations

Dipeptidyl peptidase 4 inhibitors, sodium glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists do not worsen diabetic macular edema

Alexander Phu et al. J Diabetes Complications. 2024 Aug.

Abstract

Aims: There are limited studies on dipeptidyl-peptidase 4 inhibitor (DPP-4i), sodium glucose cotransporter 2 inhibitor (SGLT2-i), and glucagon-like peptide 1 (GLP-1) receptor agonist use and occurrence of diabetic macular edema (DME). The objective of this study was to determine the association between DPP-4i, SGLT2-i, and GLP-1 receptor agonist use and occurrence of DME.

Methods: Proportional hazard models were used to evaluate the change in hazard of developing DME associated with DPP-4i, SGLT2-i, or GLP-1 receptor agonist use. Models accounted for age at DR diagnosis, DR severity (proliferative vs non-proliferative stage), time-weighted average of HbA1c level, sex, and self-reported race/ethnicity. A p-value ≤ 0.05 was considered statistically significant.

Results: The hazard ratio of developing DME after diagnosis of DR was 1.2 (CI = 0.75 to 1.99; p = 0.43) for DPP-4i use, 0.93 (CI = 0.54 to 1.61; p = 0.81) for GLP-1 receptor agonist use, 0.82 (CI = 0.20 to 3.34; p = 0.78) for SGLT2-i use, 1.1 (CI = 0.75 to 1.59; p = 0.66) for any one medication use, 1.1 (CI = 0.62 to 2.09; p = 0.68) and for any two or more medications use.

Conclusions: We did not find an association between DPP-4i, SGLT2-i, or GLP-1 receptor agonist use and increased hazard of development of DME among patients with DR.

Keywords: Diabetic macular edema; Dipeptidyl-peptidase 4 inhibitor; Glucagon-like peptide 1; Sodium glucose cotransporter 2 inhibitor.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest RMW reports receiving research support from Novo Nordisk outside the submitted work.

Figures

Figure 1:
Figure 1:
DM=diabetes mellitus, DPP-4i= dipeptidyl peptidase 4 inhibitor, GLP-1 receptor agonist= Glucagon-like peptide 1 receptor agonist, SGLT2-i= sodium glucose cotransporter 2 inhibitor, DME= diabetic macular edema, DR= diabetic retinopathy, HbA1c= hemoglobin A1c.
See this image and copyright information in PMC

References

    1. Duh EJ, Sun JK, and Stitt AW, Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI Insight, 2017. 2(14). - PMC - PubMed
    1. Ting DS, Cheung GC, and Wong TY, Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol, 2016. 44(4): p. 260–77. - PubMed
    1. Hainsworth DP, et al. , Risk Factors for Retinopathy in Type 1 Diabetes: The DCCT/EDIC Study. Diabetes Care, 2019. 42(5): p. 875–882. - PMC - PubMed
    1. Yau JW, et al. , Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care, 2012. 35(3): p. 556–64. - PMC - PubMed
    1. Stratton IM, et al. , UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia, 2001. 44(2): p. 156–63. - PubMed

MeSH terms

Substances