Hormonal
Initiating insulin glargine in patients with type 2 diabetes is associated with a higher risk of gastroparesis, intestinal obstruction, and all-cause mortality compared to initiating SGLT2 inhibitors.
If you are considering insulin glargine for type 2 diabetes, know that it is associated with a higher risk of gastroparesis, intestinal obstruction, and death compared to SGLT2 inhibitors. This does not mean insulin is bad, but it highlights the importance of choosing the right medication for your specific health profile. If you are at risk for GI issues, SGLT2 inhibitors might be a safer choice.
Compared to SGLT2i, insulin glargine had a higher hazard of gastroparesis (HR 1.29, 95% CI 1.07, 1.56), intestinal obstruction (HR 1.26, 95% CI 1.11, 1.43) and all-cause death (HR 1.58, 95% CI 1.50, 1.65).
Why this rating
Large-scale active comparator, new user design with inverse probability weighting.
Source
Glycemic therapies and the risk of gastrointestinal adverse events in veterans with type 2 diabetes
Amara Sarwal et al. · Diabetes Obesity and Metabolism · 2025
DOI 10.1111/dom.16642
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