Diabetes drugs linked to fewer harms but more genital infections
A Taiwanese observational study found urinary tract infection rates of 23.84 versus 27.88 per 1,000 person-years for two diabetes drug classes.
698,012 participants
Limit: Results may not extend beyond people with type 2 diabetes in Taiwan
An observational study in Taiwan compared 224,510 people with type 2 diabetes starting sodium-glucose cotransporter-2 inhibitors with 698,012 starting dipeptidyl peptidase-4 inhibitors. Both are classes of oral blood-sugar-lowering drugs. Participants used their new drug continuously for at least 30 days. Researchers used insurance records to emulate a trial and statistical weighting to balance participants’ starting characteristics.
Compared with the second class, the first was associated with lower rates of fractures or falls (16.55 versus 17.79), acute kidney injury (1.06 versus 1.91), bullous pemphigoid, a blistering skin disease (0.02 versus 0.07), and death (13.05 versus 19.72). Genital infection rates were higher (2.96 versus 2.05). All rates were per 1,000 person-years. Findings remained consistent across most vulnerable subgroups and individual drugs.
Why it matters
Safety concerns may limit diabetes drug use in frail people. Comparing falls, fractures and other harms addresses a prescribing question relevant to healthy aging.
Caveats
This observational comparison cannot establish that the drugs caused the differences. Participants had type 2 diabetes in Taiwan; the abstract did not specify their ages or the follow-up duration.
