Patients with type 2 diabetes who initiate therapy with SGLT2 inhibitors have a lower risk of requiring treatment for sight-threatening retinopathy compared with those using other medication classes, research from the University of Illinois Hospital and Health Sciences System in Chicago and the Mayo Clinic suggests.

SGLT2 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have gained popularity because of their benefits beyond glycemic control, including weight loss, and cardiovascular and kidney protection. However, the impact of these medications on vision-threatening retinal complications is not fully understood.

In a retrospective observational study, researchers included adults with type 2 diabetes and moderate cardiovascular disease risk who had no history of advanced diabetic retinal complications.

These patients initiated treatment with GLP-1 RA, SGLT2 inhibitors, DPP-4 inhibitors or sulfonylureas. The study used inverse probability of treatment weighting to mimic randomisation and compared the time to the first treatment for diabetic macular edema or proliferative diabetic retinopathy across the treatment groups.

GLP-1 RA did not increase retinopathy risk relative to dipeptidyl peptidase 4 inhibitors and sulfonylurea medications, the study found.

The findings were discussed by researchers at the recent American Society of Retina Specialists (ASRS) 2024 Annual Meeting in Stockholm.