{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:46:39Z","timestamp":1792439199649,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CORPD1P0071"],"award-info":[{"award-number":["CORPD1P0071"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG5M0013"],"award-info":[{"award-number":["CMRPG5M0013"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Sodium\u2013glucose cotransporter\u20102 inhibitors (SGLT2i), a class of oral hypoglycaemic agents (OHAs), have demonstrated cardiovascular and renal benefits. However, safety concerns may hinder their broader adoption, particularly among frail populations. We evaluated key safety outcomes associated with SGLT2i compared with dipeptidyl peptidase\u20104 inhibitors (DPP4i), an OHA class with low risks of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a target trial emulation (TTE) study using Taiwan's National Health Insurance Research Database (NHIRD) and enrolled participants with type 2 diabetes mellitus (T2DM). Eligible participants were categorized according to newly initiated SGLT2i (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009224,510) or newly initiated DPP4i (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009698,012) with continuous use for at least 30\u2009days. Propensity score overlap weighting (PSOW) was used to balance baseline characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the intention\u2010to\u2010treat analysis, the SGLT2i group showed significantly lower incidence rate (per person\u2010years) of several safety outcomes than the DPP4i group, including urinary tract infection (UTI) (23.84\u2030 vs. 27.88\u2030; hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.84\u20130.87), fractures or falls (16.55\u2030 vs. 17.79\u2030; HR, 0.93; 95% CI, 0.91\u20130.95), acute kidney injury (AKI) (1.06\u2030 vs. 1.91\u2030; HR, 0.55; 95% CI, 0.51\u20130.59), bullous pemphigoid (0.02\u2030 vs. 0.07\u2030; HR, 0.35; 95% CI, 0.23\u20130.54), and all\u2010cause mortality (13.05\u2030 vs. 19.72\u2030; HR, 0.66; 95% CI, 0.65\u20130.67). Conversely, the risk of genital infection was higher in the SGLT2i group (2.96\u2030 vs. 2.05\u2030; HR, 1.44; 95% CI, 1.38\u20131.51). These findings remained consistent in the per\u2010protocol analysis, across most vulnerable subgroups and individual SGLT2i and DPP4i agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SGLT2i, compared with DPP4i, demonstrated a favourable safety profile across most evaluated outcomes, except for genital infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70504","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:05:56Z","timestamp":1792436756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Key safety outcomes of\n                    <scp>SGLT2<\/scp>\n                    inhibitors versus\n                    <scp>DPP<\/scp>\n                    \u20104 inhibitors in general and vulnerable participants with\n                    <scp>T2DM<\/scp>\n                    : A target trial emulation study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7293-0149","authenticated-orcid":false,"given":"Chieh\u2010Li","family":"Yen","sequence":"first","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan City Taiwan, ROC"},{"name":"Nephrology Department Kidney Research Institute, Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-0555","authenticated-orcid":false,"given":"Pei\u2010Ru","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine Chang Gung University  Taoyuan City Taiwan, 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ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9508-5956","authenticated-orcid":false,"given":"Jia\u2010Jin","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan City Taiwan, ROC"},{"name":"Nephrology Department Kidney Research Institute, Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9256-7554","authenticated-orcid":false,"given":"Chang\u2010Chyi","family":"Jenq","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan City Taiwan, ROC"},{"name":"Nephrology Department Kidney Research Institute, Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan, 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