{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:49:49Z","timestamp":1792082989564,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the relationship of sodium\u2010glucose cotransporter\u20102 inhibitors (SGLT2i), glucagon\u2010like peptide\u20101 receptor analogues (GLP\u20101RA) and their combination (SGLT2i\u2009+\u2009GLP\u20101RA) with 5\u2010year risk of all\u2010cause mortality, hospitalization and cardiovascular\/macrovascular disease in people with type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Retrospective cohort analysis of 2.2\u2009million people with type 2 diabetes receiving insulin across 85 health care organizations using a global federated health research network. Three intervention cohorts (SGLT2i, GLP\u20101RA and SGLT2i\u2009+\u2009GLP\u20101RA) were compared against a control cohort (no SGLT2i\/GLP\u20101RA). Propensity score matching for age, ischaemic heart disease, sex, hypertension, chronic kidney disease, heart failure and glycated haemoglobin was used to balance cohorts 1:1 (SGLT2i, n\u2009=\u2009143\u2009600; GLP\u20101RA, n\u2009=\u2009186\u2009841; SGLT\u20102i\u2009+\u2009GLP\u20101RA, n\u2009=\u2009108\u2009504). A sub\u2010analysis comparing combination and monotherapy cohorts was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intervention cohorts showed a reduced hazard ratio (HR, 95% confidence interval) over 5\u2009years compared with the control cohort for all\u2010cause mortality (SGLT2i 0.49, 0.48\u20100.50; GLP\u20101RA 0.47, 0.46\u20100.48; combination 0.25, 0.24\u20100.26), hospitalization (0.73, 0.72\u20100.74; 0.69, 0.68\u20100.69; 0.60, 0.59\u20100.61) and acute myocardial infarct (0.75, 0.72\u20100.78; 0.70, 0.68\u20100.73; 0.63, 0.60\u20100.66), respectively. All other outcomes showed a significant risk reduction in favour of the intervention cohorts. The sub\u2010analysis showed a significant risk reduction in all\u2010cause mortality for combination therapy versus SGLT2i (0.53, 0.50\u20100.55) and GLP\u20101RA (0.56, 0.54\u20100.59).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SGLT2i, GLP\u20101RAs or combination therapy confers mortality and cardiovascular protection in people with type 2 diabetes over 5\u2009years. Combination therapy was associated with the greatest risk reduction in all\u2010cause mortality versus a propensity matched control cohort. In addition, combination therapy offers a reduction in 5\u2010year all\u2010cause mortality when compared directly against either monotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15185","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T22:34:21Z","timestamp":1688078061000},"page":"2897-2909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["All\u2010cause mortality and cardiovascular outcomes with\n                    <scp>sodium\u2010glucose<\/scp>\n                    Co\u2010transporter 2 inhibitors, glucagon\u2010like peptide\u20101 receptor agonists and with combination therapy in people with type 2 diabetes"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-6524","authenticated-orcid":false,"given":"David R.","family":"Riley","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Essa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"},{"name":"Department of Medicine, University Hospital Aintree Liverpool University NHS Foundation Trust  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8855-220X","authenticated-orcid":false,"given":"Philip","family":"Austin","sequence":"additional","affiliation":[{"name":"TriNetX LLC  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Preston","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"},{"name":"Department of Medicine, University Hospital Aintree Liverpool University NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isatu","family":"Kargbo","sequence":"additional","affiliation":[{"name":"TriNetX LLC  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema Hern\u00e1ndez","family":"Ibarburu","sequence":"additional","affiliation":[{"name":"TriNetX LLC  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramandeep","family":"Ghuman","sequence":"additional","affiliation":[{"name":"TriNetX LLC  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Cuthbertson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"},{"name":"Department of Medicine, University Hospital Aintree Liverpool University NHS Foundation Trust  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine University of Liverpool  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Danish Center for Clinical Health Services Research, Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Hospital Aintree Liverpool University NHS Foundation Trust  Liverpool UK"},{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Pain Research Institute University of Liverpool and Liverpool University Hospital NHS Foundation Trust  Liverpool 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