{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:59:04Z","timestamp":1789239544582,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzen Municipality","doi-asserted-by":"publisher","award":["SZSM202411021"],"award-info":[{"award-number":["SZSM202411021"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270400"],"award-info":[{"award-number":["82270400"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2023A1515010731"],"award-info":[{"award-number":["2023A1515010731"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the effectiveness of sodium\u2010glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP\u20104) inhibitors in reducing haemoglobin A1c (HbA1c) variability and improving cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and high HbA1c variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This territory\u2010wide cohort study involved patients with T2DM and an HbA1c variability score (HVS)\u2009&gt;60% who initiated SGLT2 inhibitors or DPP\u20104 inhibitors in Hong Kong between 2015 and 2022. Propensity score (PS) matching was used to adjust for confounders. The primary outcome was post\u2010treatment HVS within 3\u2009years. Secondary outcomes included major adverse cardiovascular events (MACE) and serious renal events (SRE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 20,205 T2DM patients with a baseline HVS\u2009&gt;60%, 4,612 SGLT2 inhibitor users were 1:1 matched with DPP\u20104 inhibitor users. When referencing the 0%\u201320% quintile, patients initiating SGLT2 inhibitors versus DPP\u20104 inhibitors exhibited a reduced likelihood of being in higher HVS quintiles [21%\u201340%: odds ratio (OR) 0.76, 95% confidence interval (CI) 0.66\u20130.88; 41%\u201360%: OR 0.57, 95% CI 0.50\u20130.65; 61%\u201380%: OR 0.49, 95% CI 0.42\u20130.56; and 81%\u2013100%: OR 0.40, 95% CI 0.34\u20130.47]. SGLT2 inhibitors were associated with a reduced risk of MACE [hazard ratio (HR) 0.69; 95% CI 0.60\u20130.79] and SRE (HR 0.71; 95% CI 0.63\u20130.80) compared to DPP\u20104 inhibitors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with high HbA1c variability, SGLT2 inhibitor initiation was associated with superior effectiveness in reducing HbA1c variability compared to DPP\u20104 inhibitors. The initiation of SGLT2 inhibitors versus DPP\u20104 inhibitors was linked to significantly reduced cardiovascular and renal adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16509","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T05:14:14Z","timestamp":1749791654000},"page":"4720-4728","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The effect of sodium\u2010glucose cotransporter 2 inhibitors on\n                    <scp>HbA1c<\/scp>\n                    variability and cardiovascular and renal adverse outcome in patients with\n                    <scp>T2DM<\/scp>"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-6314","authenticated-orcid":false,"given":"Ran","family":"Guo","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambarish","family":"Pandey","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanchal","family":"Chandramouli","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore, National Heart Research Institute of Singapore  Singapore Singapore"},{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u2010Zhen","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"},{"name":"Department of Geriatrics, National Key Clinical Specialty Guangzhou First People's Hospital, School of Medicine, South China University of Technology  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5587-5811","authenticated-orcid":false,"given":"An\u2010Ping","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hypertension Research Laboratory Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Xian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences &amp; Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing\u2010Wen","family":"Ren","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Yi","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Li","family":"Gu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao\u2010Chen","family":"Xuan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital  Shenzhen China"},{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"Ouwerkerk","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore, National Heart Research Institute of Singapore  Singapore Singapore"},{"name":"Department of Dermatology, Amsterdam UMC University of Amsterdam, Amsterdam Infection and Immunity Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Tromp","sequence":"additional","affiliation":[{"name":"Duke\u2010National University of Singapore Medical School  Singapore Singapore"},{"name":"Saw Swee Hock School of Public Health and National University of Singapore and National University Health System  Singapore Singapore"},{"name":"University Medical Centre Groningen, Department of Cardiology University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiew\u2010Hwa Katherine","family":"Teng","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore, National Heart Research Institute of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3394-6604","authenticated-orcid":false,"given":"Christopher Tze\u2010Wei","family":"Tsang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Yan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yik\u2010Ming","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine The University of Hong Kong, Queen Mary Hospital  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1903-0018","authenticated-orcid":false,"given":"Carolyn S. 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