Related Experiment Video

Updated: Jan 7, 2026

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
08:32

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain

Published on: January 4, 2018

10.8K

Association of Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists With Risk of

Bing-Hua Lin1, Shu-Han Chuang2, Lien-Chen Wu3

  • 1From the School of Medicine (B.H.L.), College of Medicine, Taipei Medical University, Taipei City, Taiwan.

American Journal of Ophthalmology
|December 28, 2025
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) reduce age-related cataract (ARC) risk in type 2 diabetes mellitus (T2DM) patients. SGLT2i showed a stronger protective effect than GLP-1 RA, but neither reduced cataract surgery risk.

Area of Science:

  • Ophthalmology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) is a significant risk factor for various ocular complications, including age-related cataract (ARC).
  • Antihyperglycemic agents play a crucial role in managing T2DM and may influence the progression of diabetic-related comorbidities.
  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) are commonly used as second-line therapies for T2DM.

Purpose of the Study:

  • To investigate the association between the use of SGLT2i or GLP-1 RA as second-line agents and the risk of ARC in patients with T2DM.
  • To compare the risk of ARC events between patients treated with SGLT2i plus metformin, GLP-1 RA plus metformin, and metformin monotherapy.

Main Methods:

  • A population-based retrospective cohort study utilizing the TriNetX Global Network.
  • Adults aged over 40 with T2DM were categorized into three groups: SGLT2i + metformin, GLP-1 RA + metformin, or metformin monotherapy.
  • Propensity score matching and Cox proportional hazards models were employed for pairwise comparisons with a 3-year follow-up to assess ARC incidence.

Main Results:

  • Adjunctive SGLT2i or GLP-1 RA use was associated with a reduced risk of ARC events compared to metformin monotherapy (SGLT2i HR: 0.82, GLP-1 RA HR: 0.93).
  • SGLT2i demonstrated a stronger protective effect against ARC events than GLP-1 RA (HR: 0.84).
  • The protective association was attenuated in patients with advanced age, obesity, or diabetic retinopathy; neither agent significantly reduced cataract surgery risk.

Conclusions:

  • Second-line SGLT2i or GLP-1 RA therapy in T2DM patients is linked to a lower incidence of ARC, with SGLT2i showing a more pronounced effect.
  • The findings suggest a potential benefit of these agents in mitigating ARC development, although not cataract surgery.
  • Further research is warranted to elucidate the biological mechanisms and confirm these observations.

More Related Videos

Live Images of GLUT4 Protein Trafficking in Mouse Primary Hypothalamic Neurons Using Deconvolution Microscopy08:47

Live Images of GLUT4 Protein Trafficking in Mouse Primary Hypothalamic Neurons Using Deconvolution Microscopy

Published on: December 7, 2017

10.2K
Validation of Therapeutic Agent Conjugation to Polyvinyl Alcohol-Coated Medical Devices06:34

Validation of Therapeutic Agent Conjugation to Polyvinyl Alcohol-Coated Medical Devices

Published on: November 29, 2024

568

Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
816
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
559
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
547
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
560
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
501
Oral Hypoglycemic Agents: Sulfonylureas01:17

Oral Hypoglycemic Agents: Sulfonylureas

Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
718