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Diabetology
Special Issues
Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs
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Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: 15 February 2027 | Viewed by 2975

Editors

Dr. Ângelo Jesus

E-Mail Website
Guest Editor
LAQV/REQUIMTE, Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
Interests: pharmacy; radiopharmacy; diabetes; pharmacovigilance; higher education; education sciences
Dr. Tânia Nascimento

E-Mail Website
Guest Editor
1. Escola Superior de Saúde, Campus de Gambelas, Edifício 1, Universidade do Algarve (ESSUAlg), 8005-139 Faro, Portugal
2. Algarve Biomedical Center Research Institute (ABC-RI), Campus de Gambelas, Edifício 2, Universidade do Algarve, 8005-139 Faro, Portugal
Interests: diabetes; medication adherence; glycemic control; older adults; metabolic syndrome; cardiovascular risk
Dr. Ezequiel Pinto

E-Mail Website
Guest Editor
1. Escola Superior de Saúde, Campus de Gambelas, Edifício 1, Universidade do Algarve (ESSUAlg), 8005-139 Faro, Portugal
2. Algarve Biomedical Center Research Institute (ABC-RI), Campus de Gambelas, Edifício 2, Universidade do Algarve, 8005-139 Faro, Portugal
Interests: diabetes; nutrition; medication adherence; glycemic control; older adults; metabolic syndrome; community-based study
Dr. Maryam Ferdousi

E-Mail Website
Guest Editor
Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
Interests: diabetic neuropathy; peripheral neuropathy; pain; corneal confocal microscopy

Special Issue Information

Dear Colleagues,

We are pleased to invite submissions to our Special Issue on "Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs." We welcome original research articles, systematic reviews, and meta-analyses that examine the therapeutic benefits, adverse event profiles, and real-world effectiveness of hypoglycemic agents. Of particular interest are studies that bridge the gap between controlled clinical trial data and actual clinical practice, including observational studies, and pharmacovigilance reports.

Key topics of interest include the following:

  • Comparative effectiveness and safety of novel and established hypoglycemic drugs;
  • Long-term outcomes and cardiovascular safety profiles;
  • Real-world treatment patterns and adherence;
  • Pharmacovigilance and post-marketing surveillance of hypoglycemic drugs, including signal detection, risk assessment, and management of adverse drug reactions;
  • Special populations including elderly patients, those with renal or hepatic impairment, and pregnant women;
  • Pharmacoeconomic evaluations and health outcomes research;
  • Emerging therapies and combination treatment strategies.

We look forward to receiving your valuable contributions to this important area of diabetes research.

Dr. Ângelo Jesus
Dr. Tânia Nascimento
Dr. Ezequiel Pinto
Dr. Maryam Ferdousi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diabetology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hypoglycemic drugs
  • efficacy
  • safety
  • pharmacovigilance
  • long term outcomes

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

12 pages, 964 KB  
Article
Association Between Thiazolidinediones and Solid Tumors in Patients with Diabetes: Evidence from the US Veteran Healthcare System
by Craig C. Teerlink, Tyler J. Nelson, Kathryn M. Pridgen, Fatai Y. Agiri, Mulugeta Gebregziabher, Andrew D. Schreiner, Kinfe G. Bishu, Hermes J. Florez, Richard L. Hauger and Julie A. Lynch
Diabetology 2026, 7(7), 127; https://doi.org/10.3390/diabetology7070127 - 3 Jul 2026
Viewed by 547
Abstract
Introduction: Previous research has suggested thiazolidinediones (TZDs) may be associated with certain solid tumors. We examined incidence rates over time for patients with solid tumors who received TZD treatment for diabetes. Methods: We identified medication use and diagnosis codes that were aggregated to [...] Read more.
Introduction: Previous research has suggested thiazolidinediones (TZDs) may be associated with certain solid tumors. We examined incidence rates over time for patients with solid tumors who received TZD treatment for diabetes. Methods: We identified medication use and diagnosis codes that were aggregated to phecode disease classifications derived from the nationwide Veterans Administration Health Record System from 2000 to 2021. We identified 148,139 patients who had ≥2 diabetes diagnoses and had no previous cancer diagnosis. Among these, 8981 subjects had ≥4 years of TZD exposure. We then identified subjects with ≥2 diagnosis codes for solid tumors including bladder (n = 3987), breast (n = 632), colorectal (n = 5139), esophageal (n = 482), glioma (n = 591), lung (n = 5142), melanoma (n = 1896), pancreatic (n = 726), prostate (n = 11,884), renal (n = 3145), testicular (n = 369), and thyroid (n = 513). We used multivariable Cox proportional hazards regressions to measure associations between TZD use and cancer incidence. TZD use was modeled as a time-varying covariate from the first to last prescription of TZD medication, and analyses were adjusted for age at diabetes diagnosis, self-reported race, self-reported ethnicity, sex, body mass index, and cancer site-specific polygenic risk scores. Results: Long-term (≥4 years) exposure to TZDs was significantly associated with increased risk of developing prostate cancer (HR = 1.24, p < 0.001) and decreased risk of developing lung (HR = 0.58, p < 0.001), bladder (HR = 0.51, p < 0.001), and renal cancer (HR = 0.75, p = 0.003). Conclusions: Decreased risk of developing several solid tumors (lung, bladder, and renal) indicate that TZDs may be strong candidates for drug repurposing strategies to manage these types of cancer. These results warrant replication attempts in external datasets. Full article
(This article belongs to the Special Issue Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs)
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11 pages, 616 KB  
Article
Negative Association of SGLT2 Inhibitors with Epilepsy Risk Compared with DPP-4 Inhibitors in Type 2 Diabetes: A Target Trial Emulation
by Corinna Doege, Jamschid Sedighi, Mark Luedde, Samuel Sossalla and Karel Kostev
Diabetology 2026, 7(6), 104; https://doi.org/10.3390/diabetology7060104 - 1 Jun 2026
Viewed by 757
Abstract
Background: Epilepsy is a frequent neurological comorbidity in type 2 diabetes. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) exert metabolic, vascular, and anti-inflammatory actions beyond glucose lowering, suggesting potential neuroprotective properties. We assessed whether SGLT2i use is associated with a reduced incidence of epilepsy compared with [...] Read more.
Background: Epilepsy is a frequent neurological comorbidity in type 2 diabetes. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) exert metabolic, vascular, and anti-inflammatory actions beyond glucose lowering, suggesting potential neuroprotective properties. We assessed whether SGLT2i use is associated with a reduced incidence of epilepsy compared with dipeptidyl peptidase-4 inhibitors (DPP-4i). Methods: We emulated a target trial using a retrospective observational cohort of adults with type 2 diabetes initiating SGLT2i or DPP-4i from a large real-world database. Propensity scores were estimated using a SuperLearner algorithm, and stabilized inverse probability of treatment weights were applied to balance baseline characteristics. Weighted Kaplan–Meier and Cox regression models were used to estimate hazard ratios (HRs) for incident epilepsy. Results: Among 176,728 patients (mean age 68 years; 39% women), 43% received SGLT2i. The weighted incidence of epilepsy was 2.05 versus 2.45 per 1000 person-years for SGLT2i and DPP-4i, respectively. SGLT2i treatment was associated with a significantly lower risk of epilepsy (HR 0.72, 95% CI 0.61–0.86; p < 0.001). Conclusions: In this large real-world study, initiation of SGLT2 inhibitors was associated with a lower incidence of epilepsy compared with DPP-4 inhibitors. The absolute difference in event rates was small (2.05 vs. 2.45 cases per 1000 person-years), and residual confounding cannot be excluded. These findings should therefore be regarded as hypothesis-generating and warrant prospective research to confirm causality and clarify potential mechanisms. Full article
(This article belongs to the Special Issue Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs)
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14 pages, 862 KB  
Article
Longitudinal Adherence Patterns of Oral Antidiabetics Among Older Adults with Diabetes and Concomitant Hypertension and Hyperlipidemia Using Group-Based Trajectory Modeling
by Isaiah Olumeko, Sai S. Cheruvu, Samuel C. Ofili and Susan Abughosh
Diabetology 2026, 7(5), 87; https://doi.org/10.3390/diabetology7050087 - 2 May 2026
Viewed by 929
Abstract
Background/Objectives: Diabetes is a prevalent chronic condition and a major contributor to morbidity, mortality, and healthcare costs in the U.S., particularly among older adults with comorbidities such as hypertension and dyslipidemia. Complex medication regimens increase the risk of nonadherence, which can worsen [...] Read more.
Background/Objectives: Diabetes is a prevalent chronic condition and a major contributor to morbidity, mortality, and healthcare costs in the U.S., particularly among older adults with comorbidities such as hypertension and dyslipidemia. Complex medication regimens increase the risk of nonadherence, which can worsen glycemic control, cardiovascular outcomes, and healthcare utilization. This study assessed longitudinal adherence patterns to oral antidiabetic medications among high-risk older adults and identified predictors using group-based trajectory modeling (GBTM). Methods: This retrospective cohort study used 2016–2017 Texas Medicare Advantage claims. Participants were older adults with diagnoses of diabetes, hypertension, and hyperlipidemia who had continuous plan coverage throughout the study period and at least one prescription fill for an oral antidiabetic, a statin, and a renin–angiotensin system (RAS) antagonist. Adherence was measured monthly over 12 months using the proportion of days covered (PDC). GBTM identified adherence trajectories, and multinomial logistic regression, based on the Andersen Behavioral Model, evaluated predictors using perfect adherence as the reference. Results: Among 7847 patients, three trajectories were observed: perfect adherence (59.50%), near-perfect adherence (29.21%), and rapid decline (11.29%). Female sex (OR, 1.38; 95% CI, 1.19–1.60) and absence of health plan subsidy (OR, 0.79; 95% CI, 0.68–0.92) were associated with rapid decline. Female sex (OR, 1.13; 95% CI, 1.02–1.25) and age ≥ 75 years (OR, 1.20; 95% CI, 1.00–1.43) were associated with near-perfect adherence. Conclusions: Older adults with diabetes and comorbidities exhibit distinct medication adherence patterns. Trajectory-based methods can identify those at risk for declining adherence and guide interventions to improve outcomes. Full article
(This article belongs to the Special Issue Efficacy, Safety and Real-World Evidence of Hypoglycemic Drugs)
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