Baseline characteristics of the study cohort
| Characteristic name . | Before propensity score matching . | After propensity score matching . | ||||
|---|---|---|---|---|---|---|
| GLP1-RA . | DPP4i . | SMD . | GLP1-RA . | DPP4i . | SMD . | |
| n = 496 141 . | n = 416 908 . | n = 270 129 . | n = 270 129 . | |||
| Basic demographics | ||||||
| Age at index, mean | 56.7 ± 12.9 | 63.8 ± 13.1 | 0.55 | 60.1 ± 12.1 | 60.2 ± 12.8 | 0.01 |
| Female | 268 539 (54.1) | 201 009 (48.2) | 0.12 | 136 270 (50.4) | 135 345 (50.1) | 0.01 |
| White | 284 284 (57.3) | 166 752 (40.0) | 0.35 | 139 937 (51.8) | 143 114 (53.0) | 0.02 |
| Black or African American | 88 721 (17.9) | 51 693 (12.4) | 0.15 | 42 705 (15.8) | 43 818 (16.2) | 0.01 |
| Hispanic or Latino | 52 483 (10.6) | 35 804 (8.6) | 0.07 | 28 445 (10.5) | 28 683 (10.6) | <0.01 |
| Asian | 18 804 (3.8) | 42 394 (10.2) | 0.25 | 15 462 (5.7) | 14 197 (5.3) | 0.02 |
| Examination values | ||||||
| HbA1c, mean | 8.4 ± 2.0 | 8.2 ± 1.9 | 0.11 | 8.4 ± 2.0 | 8.4 ± 2.0 | <0.01 |
| BMI, mean | 36.0 ± 8.1 | 31.0 ± 7.4 | 0.65 | 33.8 ± 7.7 | 32.9 ± 7.3 | 0.12 |
| GFR, mean | 79.2 ± 27.9 | 71.2 ± 31.2 | 0.27 | 75.5 ± 27.7 | 75.5 ± 30.4 | <0.01 |
| Diabetes medications | ||||||
| Metformin | 280 545 (56.5) | 265 189 (63.6) | 0.14 | 165 318 (61.2) | 163 607 (60.6) | 0.01 |
| Sulfonylureas | 102 899 (20.7) | 125 812 (30.2) | 0.22 | 70 510 (26.1) | 70 305 (26.0) | <0.01 |
| Alpha glucosidase inhibitors | 1 943 (0.4) | 8 188 (2.0) | 0.15 | 1 753 (0.6) | 1 424 (0.5) | 0.02 |
| Thiazolidinediones | 23 539 (4.7) | 26 867 (6.4) | 0.07 | 14 746 (5.5) | 15 273 (5.7) | 0.01 |
| SGLT2 inhibitors | 94 557 (19.1) | 54 396 (13.0) | 0.16 | 45 447 (16.8) | 44 030 (16.3) | 0.01 |
| Insulin | 196 903 (39.7) | 135 460 (32.5) | 0.15 | 97 572 (36.1) | 97 280 (36.0) | <0.01 |
| Underlying comorbidities | ||||||
| Hypertension | 310 449 (62.6) | 247 426 (59.3) | 0.07 | 167 995 (62.2) | 167 829 (62.1) | <0.01 |
| Hyperlipidemia | 299 987 (60.5) | 240 331 (57.6) | 0.06 | 161 914 (59.9) | 161 676 (59.9) | <0.01 |
| Ischemic heart diseases | 62 311 (12.6) | 71 872 (17.2) | 0.13 | 39 655 (14.7) | 39 958 (14.8) | <0.01 |
| Heart failure | 24 514 (4.9) | 26 295 (6.3) | 0.06 | 15 036 (5.6) | 15 132 (5.6) | <0.01 |
| Peripheral vascular diseases | 13 402 (2.7) | 12 310 (3.0) | 0.02 | 8 046 (3.0) | 8 330 (3.1) | 0.01 |
| Chronic kidney disease | 54 087 (10.9) | 69 656 (16.7) | 0.17 | 36 434 (13.5) | 36 657 (13.6) | <0.01 |
| Chronic obstructive pulmonary disease | 21 105 (4.3) | 21 281 (5.1) | 0.04 | 13 137 (4.9) | 13 329 (4.9) | <0.01 |
| Ischemic stroke | 10 045 (2.0) | 16 933 (4.1) | 0.12 | 7 203 (2.7) | 6 786 (2.5) | 0.01 |
| Dementia | 2 143 (0.4) | 9 338 (2.2) | 0.16 | 1 989 (0.7) | 1 701 (0.6) | 0.01 |
| Hemiplegia and hemiparesis | 1 773 (0.4) | 2 962 (0.7) | 0.05 | 1 349 (0.5) | 1 321 (0.5) | <0.01 |
| Peptic ulcer disease | 1 352 (0.3) | 5 496 (1.3) | 0.12 | 1 110 (0.4) | 851 (0.3) | 0.02 |
| Liver cirrhosis | 6 337 (1.3) | 6 133 (1.5) | 0.02 | 3 764 (1.4) | 3 834 (1.4) | <0.01 |
| Neoplasms | 69 750 (14.1) | 61 186 (14.7) | 0.02 | 39 133 (14.5) | 39 115 (14.5) | <0.01 |
| Connective tissue disease | 3 241 (0.7) | 2 602 (0.6) | 0.00 | 1 638 (0.6) | 1 616 (0.6) | <0.01 |
| HIV disease | 2 888 (0.6) | 1 759 (0.4) | 0.02 | 1 467 (0.5) | 1 481 (0.5) | <0.01 |
| COVID-19 | 19 824 (4.0) | 9 382 (2.2) | 0.10 | 7 754 (2.9) | 7 384 (2.7) | 0.01 |
| Antiplatelets | ||||||
| Aspirin | 85 779 (17.3) | 105 934 (25.4) | 0.20 | 57 198 (21.2) | 57 270 (21.2) | <0.01 |
| Ticagrelor | 4 236 (0.9) | 4 367 (1.0) | 0.02 | 2 570 (1.0) | 2 696 (1.0) | <0.01 |
| Prasugrel | 1 659 (0.3) | 1 674 (0.4) | 0.01 | 1 000 (0.4) | 1 029 (0.4) | <0.01 |
| Clopidogrel | 23 546 (4.7) | 33 964 (8.1) | 0.14 | 16 629 (6.2) | 16 567 (6.1) | <0.01 |
| Cardiovascular medications | ||||||
| Angiotensin-converting enzyme inhibitors | 143 716 (29.0) | 104 661 (25.1) | 0.09 | 79 481 (29.4) | 80 335 (29.7) | 0.01 |
| Angiotensin-2 receptor blockers | 113 719 (22.9) | 123 143 (29.5) | 0.15 | 68 302 (25.3) | 66 690 (24.7) | 0.01 |
| Aldosterone antagonists and other potassium-sparing agents | 23 866 (4.8) | 17 073 (4.1) | 0.03 | 12 115 (4.5) | 12 049 (4.5) | <0.01 |
| Beta blocking agents | 129 363 (26.1) | 134 800 (32.3) | 0.14 | 79 800 (29.5) | 79 780 (29.5) | <0.01 |
| Calcium channel blockers | 105 277 (21.2) | 132 153 (31.7) | 0.24 | 68 049 (25.2) | 66 503 (24.6) | 0.01 |
| Thiazides/related diuretics | 105 189 (21.2) | 75 471 (18.1) | 0.08 | 55 528 (20.6) | 55 760 (20.6) | <0.01 |
| Loop diuretics | 48 370 (9.7) | 51 306 (12.3) | 0.08 | 29 743 (11.0) | 30 051 (11.1) | <0.01 |
| Statins | 270 619 (54.5) | 251 771 (60.4) | 0.12 | 158 769 (58.8) | 158 507 (58.7) | <0.01 |
| Other medications | ||||||
| Hormonal contraceptives | 18 230 (3.7) | 9 185 (2.2) | 0.08 | 7 057 (2.6) | 6 597 (2.4) | 0.01 |
| Socioeconomic status | <0.01 | |||||
| Problems related to education and literacy | 303 (0.1) | 209 (0.0) | 0.00 | 157 (0.1) | 153 (0.1) | <0.01 |
| Problems related to employment and unemployment | 864 (0.2) | 438 (0.1) | 0.02 | 419 (0.2) | 384 (0.1) | <0.01 |
| Problems related to physical environment | 10 (0.0) | 0 (0.0) | 0.01 | 10 (0.0) | 0 (0.0) | 0.01 |
| Problems related to housing and economic circumstances | 2 833 (0.6) | 1 916 (0.5) | 0.02 | 1 436 (0.5) | 1 450 (0.5) | <0.01 |
| Problems related to social environment | 984 (0.2) | 821 (0.2) | 0.00 | 501 (0.2) | 535 (0.2) | <0.01 |
| Office visits and hospitalizations | ||||||
| Office or other outpatient services | 301 508 (60.8) | 160 676 (38.5) | 0.46 | 140 015 (51.8) | 140 261 (51.9) | <0.01 |
| Hospital inpatient and observation care services | 35 585 (7.2) | 36 032 (8.6) | 0.05 | 22 538 (8.3) | 23 209 (8.6) | 0.01 |
| Characteristic name . | Before propensity score matching . | After propensity score matching . | ||||
|---|---|---|---|---|---|---|
| GLP1-RA . | DPP4i . | SMD . | GLP1-RA . | DPP4i . | SMD . | |
| n = 496 141 . | n = 416 908 . | n = 270 129 . | n = 270 129 . | |||
| Basic demographics | ||||||
| Age at index, mean | 56.7 ± 12.9 | 63.8 ± 13.1 | 0.55 | 60.1 ± 12.1 | 60.2 ± 12.8 | 0.01 |
| Female | 268 539 (54.1) | 201 009 (48.2) | 0.12 | 136 270 (50.4) | 135 345 (50.1) | 0.01 |
| White | 284 284 (57.3) | 166 752 (40.0) | 0.35 | 139 937 (51.8) | 143 114 (53.0) | 0.02 |
| Black or African American | 88 721 (17.9) | 51 693 (12.4) | 0.15 | 42 705 (15.8) | 43 818 (16.2) | 0.01 |
| Hispanic or Latino | 52 483 (10.6) | 35 804 (8.6) | 0.07 | 28 445 (10.5) | 28 683 (10.6) | <0.01 |
| Asian | 18 804 (3.8) | 42 394 (10.2) | 0.25 | 15 462 (5.7) | 14 197 (5.3) | 0.02 |
| Examination values | ||||||
| HbA1c, mean | 8.4 ± 2.0 | 8.2 ± 1.9 | 0.11 | 8.4 ± 2.0 | 8.4 ± 2.0 | <0.01 |
| BMI, mean | 36.0 ± 8.1 | 31.0 ± 7.4 | 0.65 | 33.8 ± 7.7 | 32.9 ± 7.3 | 0.12 |
| GFR, mean | 79.2 ± 27.9 | 71.2 ± 31.2 | 0.27 | 75.5 ± 27.7 | 75.5 ± 30.4 | <0.01 |
| Diabetes medications | ||||||
| Metformin | 280 545 (56.5) | 265 189 (63.6) | 0.14 | 165 318 (61.2) | 163 607 (60.6) | 0.01 |
| Sulfonylureas | 102 899 (20.7) | 125 812 (30.2) | 0.22 | 70 510 (26.1) | 70 305 (26.0) | <0.01 |
| Alpha glucosidase inhibitors | 1 943 (0.4) | 8 188 (2.0) | 0.15 | 1 753 (0.6) | 1 424 (0.5) | 0.02 |
| Thiazolidinediones | 23 539 (4.7) | 26 867 (6.4) | 0.07 | 14 746 (5.5) | 15 273 (5.7) | 0.01 |
| SGLT2 inhibitors | 94 557 (19.1) | 54 396 (13.0) | 0.16 | 45 447 (16.8) | 44 030 (16.3) | 0.01 |
| Insulin | 196 903 (39.7) | 135 460 (32.5) | 0.15 | 97 572 (36.1) | 97 280 (36.0) | <0.01 |
| Underlying comorbidities | ||||||
| Hypertension | 310 449 (62.6) | 247 426 (59.3) | 0.07 | 167 995 (62.2) | 167 829 (62.1) | <0.01 |
| Hyperlipidemia | 299 987 (60.5) | 240 331 (57.6) | 0.06 | 161 914 (59.9) | 161 676 (59.9) | <0.01 |
| Ischemic heart diseases | 62 311 (12.6) | 71 872 (17.2) | 0.13 | 39 655 (14.7) | 39 958 (14.8) | <0.01 |
| Heart failure | 24 514 (4.9) | 26 295 (6.3) | 0.06 | 15 036 (5.6) | 15 132 (5.6) | <0.01 |
| Peripheral vascular diseases | 13 402 (2.7) | 12 310 (3.0) | 0.02 | 8 046 (3.0) | 8 330 (3.1) | 0.01 |
| Chronic kidney disease | 54 087 (10.9) | 69 656 (16.7) | 0.17 | 36 434 (13.5) | 36 657 (13.6) | <0.01 |
| Chronic obstructive pulmonary disease | 21 105 (4.3) | 21 281 (5.1) | 0.04 | 13 137 (4.9) | 13 329 (4.9) | <0.01 |
| Ischemic stroke | 10 045 (2.0) | 16 933 (4.1) | 0.12 | 7 203 (2.7) | 6 786 (2.5) | 0.01 |
| Dementia | 2 143 (0.4) | 9 338 (2.2) | 0.16 | 1 989 (0.7) | 1 701 (0.6) | 0.01 |
| Hemiplegia and hemiparesis | 1 773 (0.4) | 2 962 (0.7) | 0.05 | 1 349 (0.5) | 1 321 (0.5) | <0.01 |
| Peptic ulcer disease | 1 352 (0.3) | 5 496 (1.3) | 0.12 | 1 110 (0.4) | 851 (0.3) | 0.02 |
| Liver cirrhosis | 6 337 (1.3) | 6 133 (1.5) | 0.02 | 3 764 (1.4) | 3 834 (1.4) | <0.01 |
| Neoplasms | 69 750 (14.1) | 61 186 (14.7) | 0.02 | 39 133 (14.5) | 39 115 (14.5) | <0.01 |
| Connective tissue disease | 3 241 (0.7) | 2 602 (0.6) | 0.00 | 1 638 (0.6) | 1 616 (0.6) | <0.01 |
| HIV disease | 2 888 (0.6) | 1 759 (0.4) | 0.02 | 1 467 (0.5) | 1 481 (0.5) | <0.01 |
| COVID-19 | 19 824 (4.0) | 9 382 (2.2) | 0.10 | 7 754 (2.9) | 7 384 (2.7) | 0.01 |
| Antiplatelets | ||||||
| Aspirin | 85 779 (17.3) | 105 934 (25.4) | 0.20 | 57 198 (21.2) | 57 270 (21.2) | <0.01 |
| Ticagrelor | 4 236 (0.9) | 4 367 (1.0) | 0.02 | 2 570 (1.0) | 2 696 (1.0) | <0.01 |
| Prasugrel | 1 659 (0.3) | 1 674 (0.4) | 0.01 | 1 000 (0.4) | 1 029 (0.4) | <0.01 |
| Clopidogrel | 23 546 (4.7) | 33 964 (8.1) | 0.14 | 16 629 (6.2) | 16 567 (6.1) | <0.01 |
| Cardiovascular medications | ||||||
| Angiotensin-converting enzyme inhibitors | 143 716 (29.0) | 104 661 (25.1) | 0.09 | 79 481 (29.4) | 80 335 (29.7) | 0.01 |
| Angiotensin-2 receptor blockers | 113 719 (22.9) | 123 143 (29.5) | 0.15 | 68 302 (25.3) | 66 690 (24.7) | 0.01 |
| Aldosterone antagonists and other potassium-sparing agents | 23 866 (4.8) | 17 073 (4.1) | 0.03 | 12 115 (4.5) | 12 049 (4.5) | <0.01 |
| Beta blocking agents | 129 363 (26.1) | 134 800 (32.3) | 0.14 | 79 800 (29.5) | 79 780 (29.5) | <0.01 |
| Calcium channel blockers | 105 277 (21.2) | 132 153 (31.7) | 0.24 | 68 049 (25.2) | 66 503 (24.6) | 0.01 |
| Thiazides/related diuretics | 105 189 (21.2) | 75 471 (18.1) | 0.08 | 55 528 (20.6) | 55 760 (20.6) | <0.01 |
| Loop diuretics | 48 370 (9.7) | 51 306 (12.3) | 0.08 | 29 743 (11.0) | 30 051 (11.1) | <0.01 |
| Statins | 270 619 (54.5) | 251 771 (60.4) | 0.12 | 158 769 (58.8) | 158 507 (58.7) | <0.01 |
| Other medications | ||||||
| Hormonal contraceptives | 18 230 (3.7) | 9 185 (2.2) | 0.08 | 7 057 (2.6) | 6 597 (2.4) | 0.01 |
| Socioeconomic status | <0.01 | |||||
| Problems related to education and literacy | 303 (0.1) | 209 (0.0) | 0.00 | 157 (0.1) | 153 (0.1) | <0.01 |
| Problems related to employment and unemployment | 864 (0.2) | 438 (0.1) | 0.02 | 419 (0.2) | 384 (0.1) | <0.01 |
| Problems related to physical environment | 10 (0.0) | 0 (0.0) | 0.01 | 10 (0.0) | 0 (0.0) | 0.01 |
| Problems related to housing and economic circumstances | 2 833 (0.6) | 1 916 (0.5) | 0.02 | 1 436 (0.5) | 1 450 (0.5) | <0.01 |
| Problems related to social environment | 984 (0.2) | 821 (0.2) | 0.00 | 501 (0.2) | 535 (0.2) | <0.01 |
| Office visits and hospitalizations | ||||||
| Office or other outpatient services | 301 508 (60.8) | 160 676 (38.5) | 0.46 | 140 015 (51.8) | 140 261 (51.9) | <0.01 |
| Hospital inpatient and observation care services | 35 585 (7.2) | 36 032 (8.6) | 0.05 | 22 538 (8.3) | 23 209 (8.6) | 0.01 |
SGLT2, sodium-glucose cotransporter-2; SMD, standardized mean difference.