In a target emulation trial of veterans on insulin for type 2 diabetes, those adding a GLP-1 agonist did not have higher basal insulin discontinuation rates compared with those starting another diabetes drug.Roughly 17% of the veterans stopped insulin over 3 years of starting a glucose-lowering drug.Future studies should assess whether dual- or triple-incretin agonists offer an advantage, according to the researchers.
Adding a GLP-1 receptor agonist was not associated with a lower likelihood of discontinuing existing basal insulin therapy among veterans with type 2 diabetes compared with other glucose-lowering agents, a target emulation trial found.
Over a 3-year follow-up, insulin therapy was discontinued by 16.7% of GLP-1 drug initiators, 17.9% of SGLT2 inhibitor initiators, and 17.1% of DPP-4 inhibitor initiators in an intention-to-treat analysis, according to researchers led by Kasia Lipska, MD, MHS, of the Veterans Affairs Connecticut Healthcare System in West Haven.
Neither difference in insulin discontinuation reached statistical significance, with risk ratios of 0.93 (95% CI 0.86-1.01) for GLP-1 drugs versus SGLT2 inhibitors and 0.98 (95% CI 0.87-1.09) for GLP-1 drugs versus DPP-4 inhibitors.
