Sodium-Glucose Cotransporter 2 Inhibitors and Reduced Fibromyalgia Risk in Patients With Diabetes: A Target Trial

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Yi-Sheng Jhang1,2, Hsin-Yo Lu3, Chen-Yu Lin3

  • 1Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan, R.O.C.

In Vivo (Athens, Greece)
|January 2, 2026
PubMed
Abstract

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) may reduce fibromyalgia risk in diabetic patients compared to glucagon-like peptide-1 receptor agonists (GLP-1RA). This large real-world study found SGLT2i associated with lower new-onset fibromyalgia incidence.

Area of Science:

  • Endocrinology
  • Neurology
  • Pharmacology

Background:

  • Emerging evidence suggests neuroprotective properties of SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1RA).
  • Diabetic patients are at risk for various complications, including potential neurological conditions.

Purpose of the Study:

  • To compare the risk of new-onset fibromyalgia in type 2 diabetic patients initiating SGLT2 inhibitors versus GLP-1 receptor agonists.
  • To evaluate the potential differential neuroprotective effects of these two common diabetes medication classes.

Main Methods:

  • A target trial emulation using the TriNetX Global Collaborative Network.
  • Propensity score-matching (1:1) of adult type 2 diabetic patients initiating SGLT2i or GLP-1RA, excluding prior fibromyalgia or psychiatric disorders.
  • Estimation of hazard ratios (HRs) for new-onset fibromyalgia incidence.

Main Results:

  • Analysis included 297,937 patients per group after matching.
  • SGLT2i use was associated with a significantly lower risk of fibromyalgia (HR=0.896, 95% CI=0.867-0.925).
  • This association remained consistent across 1-, 3-, and 5-year follow-up periods.

Conclusions:

  • In a large real-world cohort, SGLT2 inhibitors demonstrated a reduced risk of new-onset fibromyalgia compared to GLP-1 receptor agonists in diabetic patients.
  • Findings suggest potential differential neuroprotective effects between SGLT2i and GLP-1RA in managing type 2 diabetes.
Keywords:
FibromyalgiaSGLT2 inhibitorselectronic medical recordsepidemiologyglucose-lowering drugs

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