The link between certain glucose-lowering drugs and diabetic retinopathy risk remains uncertain in patients with diabetes, researchers concluded after conducting a meta-analysis of 37 trials involving >100,000 individuals. Participants had diabetes for an average of 8.7 years, and their mean baseline HbA1c was 8.2%. Among the findings for both network and pairwise meta-analyses:

• In the network meta-analysis, DPP-4 inhibitors, GLP1 agonists, and SGLT2 inhibitors were not linked with a higher risk of diabetic retinopathy, when compared with placebo.

• The pairwise meta-analysis showed that patients taking DPP-4 inhibitors had a 27% higher risk of diabetic retinopathy.

• Patients taking sulfonylureas had a 67% higher risk of such, vs placebo.

The authors noted that diabetic retinopathy events were not systematically assessed, and suggested that the effects of sulfonylureas be explored further in large-scale, well-designed studies.