Abstract
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) play a key role in managing type 2 diabetes mellitus (T2DM). Transitioning between different GLP-1RA has been proposed as a treatment strategy. AIM: To investigate switching patterns between GLP-1RA and their impact on glycemic control. METHODS: A retrospective study involving patients with T2DM who initiated GLP-1RA therapy between 2009 and 2021 and transitioned to another GLP-1RA. Baseline glycated hemoglobin (HbA(1c)) was defined as the most recent measurement within 1 year prior to switching, and follow-up HbA(1c) was the first measurement recorded 4-15 months post-switch. RESULTS: Among 70654 patients initiating GLP-1RA therapy, 18047 (25.5%) switched regimens. In the 13970 patients with available HbA(1c), levels decreased from 8.5% ± 1.6% to 7.6% ± 1.4% (P < 0.001). HbA(1c) decreased in 78.3% (10943/13970) of these patients, with the most frequent improvement observed in those switching from daily to weekly GLP-1RA (81%, 5582/6890). CONCLUSION: Switching between GLP-1RAs can serve as a practical alternative to treatment intensification for effectively managing T2DM.