The influence of dapagliflozin on diabetic ocular complications: An observational cohort study

This study aimed to evaluate the risk of developing ocular outcomes, including diabetic retinopathy (DR), open-angle glaucoma (OAG), and visual loss, in patients with type 2 diabetes mellitus (T2DM) treated with dapagliflozin, a sodium glucose cotransporter 2 inhibitor (SGLT2i), compared to those receiving other hypoglycemic agents.

This was an observational, retrospective, multi-center cohort study using data from the Taipei Medical University Clinical Research Database (2016-2020). Participants included 18,854 newly diagnosed T2DM patients with an estimated glomerular filtration rate above 45 ml/min/m². After excluding those with a history of DR, OAG, or visual loss, 1400 dapagliflozin users and 1400 non-SGLT2i users were matched using 1:1 propensity score matching. The primary outcome was the composite incidence of DR, OAG, or visual loss.

After 1-year follow-up, dapagliflozin users had a significantly lower incidence of DR, OAG, or visual loss (2.78 % vs. 5.35 %; adjusted hazard ratio [aHR], 0.53; 95 % CI, 0.36-0.79, p = 0.002). At the 2-year follow-up, the incidence was 3.85 % in dapagliflozin users compared to 6.35 % in non-SGLT2i users (aHR, 0.63; 95 % CI, 0.44-0.88, p = 0.007).

Dapagliflozin was associated with a significantly lower incidence of DR, OAG, or visual loss in newly diagnosed T2DM patients within five years, suggesting its potential benefit in preventing ocular complications.