SGLT-2 Inhibitors vs. Sulfonylureas in Patients with Type 2 Diabetes Who Use Metformin

For patients with type 2 diabetes who take metformin and have suboptimal glycemic control, the comparative effectiveness of sulfonylureas and sodium–glucose cotransporter (SGLT)-2 inhibitors as second-line agents is unclear. In this cohort study from the U.S. Veterans Affairs healthcare system, researchers examined outcomes for 128,000 patients with type 2 diabetes who were taking metformin and were new users of sulfonylureas (81%) or SGLT-2 inhibitors (19%). Mean age was 65, 95% were men, and mean glycosylated hemoglobin (HbA_1c) level was 8.6%.

Propensity scoring was used to adjust for baseline differences between SGLT-2 and sulfonylurea users. During mean follow-up of 2.2 years, new use of SGLT-2 inhibitors was associated with significant …