The study covered in this summary was published on medRxiv.com as a preprint and has not yet been peer reviewed.
Key Takeaways
Treatment with metformin significantly linked with reduced mortality in people with type 2 diabetes compared with treatment with other antidiabetes drug classes, but metformin did not produce survival rates that matched people without diabetes.
Treatment with a sodium-glucose cotransporter 2 inhibitor (SGLT2i) also significantly associated with increased longevity compared with treatment with other glucose-lowering medications. Survival of people with type 2 diabetes on SGLT2i treatment approximated that of people without diabetes, and SGLT2i treatment also linked with significantly lower cancer-related mortality.
Why This Matters
Previous studies had limited follow-up duration, small sample sizes, excluded people with preexisting malignancies, and didn't compare survival with matched individuals without type 2 diabetes.
Assessing changes in survival linked with various glucose-lowering medications can guide selection of second-line agents.
The results should encourage clinicians to consider metformin and an SGLT2i agent for either single- or dual-drug first-line treatment of people with type 2 diabetes.
Study Design
Prospective population-based study of 410,389 UK Biobank adults enrolled during 2006–2010, including 43,610 diagnosed with type 2 diabetes at entry.
Among those with type 2 diabetes, 57% were taking metformin, 21% insulin16% a sulfonylurea, 14% a dipeptidyl peptidase 4 inhibitor (DPP4i), 8% an SGLT2i, and 4.2% a glucagon-like peptide-1 receptor agonist (GLP-1RA). Fewer than 2% were taking other agents.
