{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:55:19Z","timestamp":1774482919746,"version":"3.50.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bundesministerium f\u00fcr\n                        Gesundheit","award":["German Diabetes Center (DDZ)"],"award-info":[{"award-number":["German Diabetes Center (DDZ)"]}]},{"DOI":"10.13039\/501100007885","name":"European Association for the Study\n                        of Diabetes","doi-asserted-by":"crossref","award":["Early career mentorship program (Tim Mori)"],"award-info":[{"award-number":["Early career mentorship program (Tim Mori)"]}],"id":[{"id":"10.13039\/501100007885","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100031584","name":"Deutsches Zentrum f\u00fcr\n                        Diabetesforschung","doi-asserted-by":"crossref","award":["82DZD14H03"],"award-info":[{"award-number":["82DZD14H03"]}],"id":[{"id":"10.13039\/100031584","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100014690","name":"Ministerium f\u00fcr Kultur und\n                        Wissenschaft des Landes Nordrhein-Westfalen","doi-asserted-by":"crossref","award":["German Diabetes Center (DDZ)"],"award-info":[{"award-number":["German Diabetes Center (DDZ)"]}],"id":[{"id":"10.13039\/501100014690","id-type":"DOI","asserted-by":"crossref"}]},{"name":"HORIZON EUROPE European Innovation\n                        Council","award":["101095556"],"award-info":[{"award-number":["101095556"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Guidelines recommend GLP-1 receptor agonists (GLP-1-RA) and SGLT2-inhibitors\n                        (SGLT2i) for individuals with type 2 diabetes (T2D) at high risk of\n                        atherosclerotic cardiovascular disease (ASCVD). In the context of precision\n                        medicine, we evaluated a personalized treatment algorithm to guide the\n                        initial decision between these therapies.<\/jats:p>\n                  <jats:p>Using data from the observational Diabetes Prospective Follow-up registry\n                        (Germany\/Austria) we studied individuals with T2D who initiated GLP-1-RA\n                        (n=1433) or SGLT2i (n=2547) in a multicenter, real-world setting. Baseline\n                        characteristics included age, sex, body mass index (BMI), estimated\n                        glomerular filtration rate (eGFR), HbA1c, diabetes duration, and history of\n                        ASCVD. Non-fatal ASCVD events (myocardial infarction, angina,\n                        revascularization, stroke, transient ischemic attack, and peripheral artery\n                        disease) were analyzed using dynamic weighted survival modeling to predict\n                        the optimal treatment for each individual.<\/jats:p>\n                  <jats:p>The algorithm predicted 48% of individuals to have better ASCVD outcomes with\n                        GLP-1-RA and 52% with SGLT2i. GLP-1-RA-optimal individuals had on average a\n                        higher BMI (37 vs 31 kg\/m2), lower eGFR (71 vs 93 ml\/min per 1.73\n                            m2) and less history of ASCVD (9 vs 18%) compared to\n                        SGLT2i-optimal individuals. However, an internal model validation showed\n                        that the predicted optimal treatment did not statistically significantly\n                        prolong the average time to a non-fatal ASCVD event compared to the\n                        suboptimal treatment (AFT parameter: 1.13; 95% CI: 0.83-1.56; HR: 0.88; 95%\n                        CI: 0.64-1.21).<\/jats:p>\n                  <jats:p>The personalized treatment algorithm for GLP-1-RA and SGLT2i did not result\n                        in clear individual ASCVD benefits on either drug, a finding consistent with\n                        the clinical equipoise reflected in current T2D treatment guidelines.<\/jats:p>","DOI":"10.1055\/a-2798-6496","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:30:26Z","timestamp":1774481426000},"page":"79-87","source":"Crossref","is-referenced-by-count":0,"title":["GLP-1 receptor agonists or SGLT2-inhibitors? Evaluation of a\n                    personalized treatment algorithm for individuals with type 2 diabetes: a\n                    registry-based cohort study"],"prefix":"10.1055","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8363-7434","authenticated-orcid":false,"given":"Tim","family":"Mori","sequence":"additional","affiliation":[{"name":"German Diabetes Center Institute for Biometrics and\n                    Epidemiology, D\u00fcsseldorf, Germany"},{"name":"German Center for Diabetes Research, Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3301-5869","authenticated-orcid":false,"given":"Oliver","family":"Ku\u00df","sequence":"additional","affiliation":[{"name":"German Diabetes Center Institute for Biometrics and\n                    Epidemiology, D\u00fcsseldorf, Germany"},{"name":"German Center for Diabetes Research, Neuherberg,\n                    Germany"},{"name":"Centre for Health and Society, Heinrich Heine University\n                    D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4233","authenticated-orcid":false,"given":"Julia K.","family":"Mader","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical University of\n                    Graz, Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Naudorf","sequence":"additional","affiliation":[{"name":"Diabetes Center Lindlar, Lindlar, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5654-7310","authenticated-orcid":false,"given":"Jochen","family":"Seufert","sequence":"additional","affiliation":[{"name":"Department of Medicine II, Medical Center \u2013 University\n                    of Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-4842","authenticated-orcid":false,"given":"Reinhard W.","family":"Holl","sequence":"additional","affiliation":[{"name":"Ulm University Institute of Epidemiology & Medical\n                    Biometry, Ulm, Germany"},{"name":"German Center for Diabetes Research, Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3789-6459","authenticated-orcid":false,"given":"Stefanie","family":"Lanzinger","sequence":"additional","affiliation":[{"name":"Ulm University Institute of Epidemiology & Medical\n                    Biometry, Ulm, Germany"},{"name":"German Center for Diabetes Research, Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3627-1163","authenticated-orcid":false,"given":"Julia M.","family":"Grimsmann","sequence":"additional","affiliation":[{"name":"Ulm University Institute of Epidemiology & Medical\n                    Biometry, Ulm, Germany"},{"name":"German Center for Diabetes Research, Neuherberg,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.2337\/dci22-0034","article-title":"Management of hyperglycemia in type 2 diabetes, 2022. 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care"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2438","DOI":"10.1038\/s41591-023-02502-5","article-title":"Second international consensus report on gaps and opportunities for the clinical\n                    translation of precision diabetes medicine","volume":"29","author":"D K Tobias","year":"2023","journal-title":"Nat Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1038\/s43856-023-00359-w","article-title":"Treatment effect heterogeneity following type 2 diabetes treatment with\n                    GLP1-receptor agonists and SGLT2-inhibitors: a systematic review","volume":"3","author":"K G Young","year":"2023","journal-title":"Commun Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.2337\/dbi20-0002","article-title":"Precision medicine in type 2 diabetes: using individualized prediction models to\n                    optimize selection of treatment","volume":"69","author":"J M Dennis","year":"2020","journal-title":"Diabetes"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e873","DOI":"10.1016\/S2589-7500(22)00174-1","article-title":"Development of a treatment selection algorithm for SGLT2 and DPP-4 inhibitor\n                    therapies in people with type 2 diabetes: a retrospective cohort study","volume":"4","author":"J M Dennis","year":"2022","journal-title":"The Lancet Digital Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1007\/s00125-024-06099-3","article-title":"Phenotype-based targeted treatment of SGLT2 inhibitors and GLP-1 receptor\n                    agonists in type 2 diabetes","volume":"67","author":"P Cardoso","year":"2024","journal-title":"Diabetologia"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1080\/01621459.2019.1629939","article-title":"Estimating optimal dynamic treatment regimes with survival outcomes","volume":"115","author":"Investigators 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Metab"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"4116","DOI":"10.1111\/dom.15741","article-title":"Regional socioeconomic deprivation associated with the use of sodium-glucose\n                    cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in\n                    adults with type 2 diabetes in Germany","volume":"26","author":"M Auzanneau","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1111\/dom.16149","article-title":"Effectiveness of add-on therapy with SGLT2 inhibitors or GLP-1 receptor agonists\n                    in adults with type 1 diabetes: A prospective DPV registry study","volume":"27","author":"C Baechle","year":"2025","journal-title":"Diabetes Obes Metab"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1038\/nrrheum.2015.30","article-title":"Active-comparator design and new-user design in observational 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Epidemiology\n                    (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"E Von Elm","year":"2007","journal-title":"The lancet"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1038\/s41591-024-03033-3","article-title":"Reporting guidelines for precision medicine research of clinical relevance: the\n                    BePRECISE checklist","volume":"30","author":"S S Lim","year":"2024","journal-title":"Nat Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"672","DOI":"10.2337\/db24-0688","article-title":"Comparison of the Effects of SGLT-2i versus GLP-1RA on Cardiovascular and Renal\n                    Outcomes in Patients with Type 2 Diabetes Mellitus based on Baseline Renal\n                    Function","volume":"74","author":"Y Wang","year":"2025","journal-title":"Diabetes"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.7326\/L21-0708","article-title":"Sodium\u2013glucose cotransporter-2 inhibitors versus glucagon-like peptide-1\n                    receptor agonists and the risk for cardiovascular outcomes in routine care\n                    patients with diabetes across categories of cardiovascular disease","volume":"174","author":"E Patorno","year":"2021","journal-title":"Annals of internal medicine"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101882","article-title":"Pharmacotherapy of obesity: an update on the available medications and drugs\n                    under investigation","volume":"58","author":"M Chakhtoura","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1016\/j.jacc.2024.05.069","article-title":"Comparative Effectiveness of Second-line Antihyperglycemic Agents for\n                    Cardiovascular 2 Outcomes: A Multinational, Federated Analysis of\n                    LEGEND-T2DM","volume":"84","author":"R Khera","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1146\/annurev-statistics-030718-105251","article-title":"Precision medicine","volume":"6","author":"M R Kosorok","year":"2019","journal-title":"Annual review of statistics and its application"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1007\/s00125-023-05951-2","article-title":"How amenable is type 2 diabetes treatment for precision diabetology? A\n                    meta-regression of glycaemic control data from 174 randomised trials","volume":"66","author":"O Kuss","year":"2023","journal-title":"Diabetologia"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1111\/dom.15519","article-title":"Assessing the potential for precision medicine in body weight reduction with\n                    regard to type 2 diabetes mellitus therapies: A meta-regression analysis of 120\n                    randomized controlled trials","volume":"26","author":"K G Vargas","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1007\/s00592-024-02425-8","article-title":"The potential of precision diabetology for type 2 diabetes treatment \u2013 evidence\n                    from a meta-regression for all-cause mortality from large cardiovascular outcome\n                    trials","volume":"62","author":"O Kuss","year":"2024","journal-title":"Acta Diabetol"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2798-6496.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:30:32Z","timestamp":1774481432000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2798-6496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":32,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,3,25]]},"published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2798-6496","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}