One-year usage patterns of SGLT-2 inhibitors and GLP-1 receptor agonists in individuals with type 2 diabetes in a real-world population.

Donnelly LA, Singh K, McCrimmon RJ, Pearson ER

Diabetes, obesity & metabolism4 Nov 2025Cited by 5 (Europe PMC)

PMID41189335PMCIDPMC12803620DOI10.1111/dom.70269PepBankPUB-41189335

Summary

AimsReal-world studies of sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) typically assess adherence and discontinuation as separate outcomes. We applied a novel approach that integrates these measures to categorize patterns of drug usage. We describe patterns across individual subclasses, and in overall class-level models, we examined clinical characteristics associated with each category with particular interest in poor adherence and intolerance.Materials and methodsWe conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA. Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.ResultsAmong SGLT2is, poor adherence was more common in younger individuals, with greater socioeconomic deprivation, and higher HbA_1c, while intolerance was more frequent in older, leaner females and in those with prior genital thrush. For GLP-1RAs, newer agents were associated with more favourable usage patterns. Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide. In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.ConclusionsDistinct clinical and biochemical characteristics are associated with poor adherence versus discontinuation. Understanding these patterns is crucial for developing targeted strategies to improve sustained use, ultimately enhancing treatment outcomes for people with type 2 diabetes.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study14

4 results from studies that gave the peptide. 4 results from people.

01HumanObservational studyOther
In people with type 2 diabetes, poor adherence was more frequent with liraglutide than semaglutide.
In plain wordsIn people with type 2 diabetes, poor adherence was more common with liraglutide than semaglutide.
Peptide
Liraglutide
Outcome
IncreasePoor adherence
Study
n: not reported in source
Comparator
Semaglutide
Outcome group
Treatment adherence and retention · Pharmacology
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
2 context sentences(design, population, supporting numbers)
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
Show in the study text Report a problemFND-4118933501
02HumanObservational studyOther
In people with type 2 diabetes, poor adherence was less frequent with semaglutide than liraglutide.
In plain wordsIn people with type 2 diabetes, poor adherence was less common with semaglutide than liraglutide.
Peptide
Semaglutide
Outcome
DecreasePoor adherence
Study
n: not reported in source
Comparator
Liraglutide
Outcome group
Treatment adherence and retention · Pharmacology
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
2 context sentences(design, population, supporting numbers)
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
Show in the study text Report a problemFND-4118933502
03HumanObservational studyOther
In a one-year cohort of people with type 2 diabetes, poor adherence was less frequent with semaglutide than lixisenatide.
In plain wordsIn people with type 2 diabetes followed for one year, poor adherence was less common with semaglutide than lixisenatide.
Peptide
Semaglutide
Outcome
DecreasePoor adherence
Study
n: not reported in source
Comparator
Lixisenatide
Outcome group
Treatment adherence and retention · Pharmacology
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
2 context sentences(design, population, supporting numbers)
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
Show in the study text Report a problemFND-4118933513
04HumanObservational studyOther
In a one-year cohort of people with type 2 diabetes, poor adherence was less frequent with semaglutide than exenatide.
In plain wordsIn people with type 2 diabetes followed for one year, poor adherence was less common with semaglutide than exenatide.
Peptide
Semaglutide
Outcome
DecreasePoor adherence
Study
n: not reported in source
Comparator
Exenatide
Outcome group
Treatment adherence and retention · Pharmacology
Studied dose
Dose not stated · 1 yearAs given in this study (human).
Source sentences
Summary
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
2 context sentences(design, population, supporting numbers)
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
Show in the study text Report a problemFND-4118933514

Studies that did not test the peptide alone10

In this study, the peptide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking the peptide.

05HumanNot a test of Liraglutide aloneObservational studyOther
In people with type 2 diabetes, younger age was associated with poor adherence across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, younger age was linked to poor adherence across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Liraglutide
Outcome
Direction not reportedPoor adherence and younger age
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4118933503
06HumanNot a test of Semaglutide aloneObservational studyOther
In people with type 2 diabetes, younger age was associated with poor adherence across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, younger age was linked to poor adherence across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Semaglutide
Outcome
Direction not reportedPoor adherence and younger age
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4118933504
07HumanNot a test of Liraglutide aloneObservational studyOther
In people with type 2 diabetes, prior GLP-1 receptor agonist use was associated with poor adherence across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, prior GLP-1 drug use was linked to poor adherence across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Liraglutide
Outcome
Direction not reportedPoor adherence and prior GLP-1 receptor agonist use
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4118933505
08HumanNot a test of Semaglutide aloneObservational studyOther
In people with type 2 diabetes, prior GLP-1 receptor agonist use was associated with poor adherence across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, prior GLP-1 drug use was linked to poor adherence across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Semaglutide
Outcome
Direction not reportedPoor adherence and prior GLP-1 receptor agonist use
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4118933506
09HumanNot a test of Liraglutide aloneObservational studyOther
In people with type 2 diabetes, lower BMI was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, lower body mass index was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Liraglutide
Outcome
Direction not reportedIntolerance and lower body mass index
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4118933507
10HumanNot a test of Semaglutide aloneObservational studyOther
In people with type 2 diabetes, lower BMI was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, lower body mass index was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Semaglutide
Outcome
Direction not reportedIntolerance and lower body mass index
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4118933508
11HumanNot a test of Liraglutide aloneObservational studyOther
In people with type 2 diabetes, female sex was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, female sex was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Liraglutide
Outcome
Direction not reportedIntolerance and female sex
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4118933509
12HumanNot a test of Semaglutide aloneObservational studyOther
In people with type 2 diabetes, female sex was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, female sex was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Semaglutide
Outcome
Direction not reportedIntolerance and female sex
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4118933510
13HumanNot a test of Liraglutide aloneObservational studyOther
In people with type 2 diabetes, more advanced chronic kidney disease was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, advanced kidney disease was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Liraglutide
Outcome
Direction not reportedIntolerance and advanced chronic kidney disease
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4118933511
14HumanNot a test of Semaglutide aloneObservational studyOther
In people with type 2 diabetes, more advanced chronic kidney disease was linked to intolerance across GLP-1 receptor agonists including liraglutide and semaglutide.
In plain wordsIn type 2 diabetes, advanced kidney disease was linked to intolerance across GLP-1 drugs including liraglutide and semaglutide.
Peptide
Semaglutide
Outcome
Direction not reportedIntolerance and advanced chronic kidney disease
Study
n: not reported in source
Outcome group
Treatment adherence and retention · Pharmacology
Source sentences
Summary
In addition, poor adherence was associated with younger age and prior GLP-1RA use, while intolerance was linked to lower BMI, female sex, and more advanced CKD.
4 context sentences(design, population, supporting numbers)
Summary · context
For GLP-1RAs, newer agents were associated with more favourable usage patterns.
Summary · context
Poor adherence was more frequent with liraglutide, lixisenatide, and exenatide compared to semaglutide, and intolerance was more common with lixisenatide.
Summary · context
We conducted an observational cohort study using electronic health records from the Scottish Care Information Diabetes Collaboration database, including individuals with type 2 diabetes who initiated a SGLT2i or GLP-1RA.
Summary · context
Each initiation was followed for 1 year and classified into five mutually exclusive groups: adherent, poor adherence and three discontinuation categories including a proxy for intolerance.
In this study, Semaglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Semaglutide.
Show in the study text Report a problemFND-4118933512

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 4Current
27 Oct 2026, 16:36 UTC
Study data updated · source update from Europe PMC
Version 3
12 Oct 2026, 11:11 UTC
Study results updated
Version 2
9 Oct 2026, 03:06 UTC
Study data updated · source update from Europe PMC
Version 1
9 Oct 2026, 03:05 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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