Differential Cardiometabolic Effects of GLP-1 Receptor Agonists Versus SGLT2 Inhibitors in Early-Onset Type 2 Diabetes: A Randomized Controlled Trial
DOI:
https://doi.org/10.61919/061x6w21Keywords:
Cardiovascular Risk Markers, Early-Onset Diabetes, GLP-1 Receptor Agonists, Glycated Hemoglobin, Lipid Profile, SGLT2 Inhibitors, Type 2 Diabetes Mellitus.Abstract
Introduction: Early-onset type 2 diabetes mellitus is characterized by higher exposure to cardiometabolic risk throughout life and increased risk of cardiovascular morbidity. GLP-1 receptor agonists and SGLT2 inhibitors improve the markers of cardiometabolic risk; however, a comparison between the therapies is poorly represented in the literature regarding younger population. Objective: Comparative study of the short-term effects of GLP-1 receptor agonist and SGLT2 inhibitor therapy on the markers of cardiometabolic risk in patients with early-onset type 2 diabetes mellitus. Methods: A randomized parallel group clinical trial was conducted in 84 patients with early-onset type 2 diabetes mellitus. Patients were randomized to receive once weekly GLP-1 receptor agonist therapy or once daily SGLT2 inhibitor therapy for 6 weeks. Main outcomes were changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and lipid profile. Secondary outcomes were BMI, HbA1c, fasting glucose, and frequency of treatment discontinuation due to adverse events. Results: 79 patients completed follow up and were included into available case analysis. Post-intervention SBP and DBP values were lower in SGLT2 inhibitor group in comparison with GLP-1 receptor agonist group. LDL-C values were lower in GLP-1 receptor agonist group. Mean reduction in SBP value was 8.9 ± 3.1 mmHg in GLP-1RA group vs 10.8 ± 3.5 mmHg in SGLT2 inhibitor group. Mean reduction in LDL-C level was 18.5 ± 6.2 mg/dL in GLP-1RA group and 9.2 ± 5.8 mg/dL in SGLT2 inhibitor group. Conclusion: Both therapeutic interventions led to short-term improvement of the cardiometabolic risk markers in patients with early-onset type 2 diabetes with different beneficial effects of SGLT2 inhibitors on blood pressure reduction and GLP-1RA on LDL-C level reduction
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Copyright (c) 2026 Marriam Abid, Samia Gull Akhtar, Tabinda Razzaq, Zia Ullah, Shah Abdul Latif, Hafiz Muhammad Qasim, Muhammad Abbas Sadiq (Author)
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