Do SGLT-2 Inhibitors and GLP-1 Receptor Agonists Lower Hyperkalemia Risk in Type 2 Diabetes?

Patients with type 2 diabetes are at risk for hyperkalemia, particularly when they also have heart failure or chronic kidney disease (CKD) or take renin-angiotensin-aldosterone system (RAAS) inhibitors. Limited evidence suggests that sodium–glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists might lower risk for hyperkalemia in these patients.

Using Medicare and U.S. commercial insurance databases, investigators identified 2.4 million adults with type 2 diabetes who started using SGLT-2 inhibitors, GLP-1 receptor agonists, or dipeptidyl peptidase-4 (DPP-4) inhibitors between 2013 and 2022 and created ≈400,000 propensity-matched pairs of patients for each possible pairwise comparison of the three …