[Articles] Frailty-stratified effectiveness of SGLT2 inhibitors versus DPP-4 inhibitors and GLP-1 receptor agonists on pulmonary outcomes in type 2 diabetes: a nationwide cohort study

Compared with DPP-4i, SGLT2i reduced the composite pulmonary endpoint overall, prevented COPD hospitalizations primarily in fit or mildly frail patients, and conferred protection against pneumonia admissions across most frailty strata, while showing comparable benefits to GLP-1 RA. These findings suggest that both SGLT2i and GLP-1 RA may be preferred options for T2D patients with COPD, with effectiveness influenced by frailty status.

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Optimal Data Sources for Studies of Incident Dementia

In JAMA Internal Medicine, Luchsinger et al describe the results of a prespecified secondary analysis of the GRADE clinical trial on cognitive performance. The GRADE trial randomized 3721 patients with type 2 diabetes using metformin at baseline to add either a long-acting insulin, a sulfonylurea, a glucagon-like peptide-1 (GLP-1) agonist, or a dipeptidyl peptidase-4 inhibitor. At 4 years following randomization, cognitive performance was not different between treatment groups across 3 validated cognitive tests. However, worsened glycemic control was associated with modestly lower cognitive test scores. These findings provide important data for clinicians, particularly in light of recent lay press and scientific enthusiasm about GLP-1 agonists for dementia prevention.

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FDA Accepts Application for Oral Version of Wegovy

The US Food and Drug Administration (FDA) recently accepted a new drug application for oral semaglutide. If approved, it would be the first oral glucagon-like peptide-1 (GLP-1) receptor agonist authorized for long-term weight management. The 25-mg semaglutide pill would be marketed as Wegovy, the same name used for Novo Nordisk’s FDA-approved 2.4-mg semaglutide injection.

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