Validation of an algorithm for selection of SGLT2 and DPP4 inhibitor therapies in people with type 2 diabetes across major UK ethnicity groups: a retrospective cohort study

作者：Laura M. Güdemann, Katherine Young, Pedro Cardoso, Bilal A. Mateen, Rury R. Holman, Naveed Sattar, Ewan R. Pearson, Andrew T. Hattersley, Angus G. Jones, Beverley M. Shields, John Dennis, Lauren R. Rodgers, William Henley, Timothy J. McDonald, Michael N. Weedon, Nicky Britten, Catherine Angwin, Robert S. Lindsay, Christopher Jennison, Mark Walker, Kennedy Cruickshank, Salim Janmohamed, Christopher Hyde, Andrew Farmer, Alastair Gray, Stephen Gough, Olorunsola F. Agbaje, Trevelyan J. McKinley, Sebastian J. Vollmer, William Hamilton, Rhian Hopkins · 发表于：The Lancet Regional Health - Europe · 年份：2025 · DOI：10.1016/j.lanepe.2025.101547 · 被引用次数：2 · 研究领域：Diabetes Treatment and Management、Pancreatic function and diabetes、Chronic Kidney Disease and Diabetes

Background: Routine clinical features of individual patients can potentially be used to guide selection of type 2 diabetes treatments. We aimed to evaluate a recently proposed treatment selection model predicting differences in glycaemic responses to SGLT2-inhibitors and DPP4-inhibitors across major UK ethnicity groups. Methods: We externally validated the SGLT2i-DPP4i model in UK primary care cohort (CPRD Aurum, 2013-2020) independent of the original model development cohort. Non-insulin treated individuals with type 2 diabetes were identified and categorised by major UK self-reported ethnicity groups: White, Black, South Asian and Mixed/Other. For each ethnicity group, we applied a closed testing procedure to assess whether model recalibration was required. After model updates, we assessed the calibration accuracy of predicted differences in glycaemic response (6-month change in HbA1c) between SGLT2i and DPP4i for each ethnicity group. Findings: SGLT2i (n = 57,749) and DPP4i (n = 87,807) initiations were identified amongst people of White (n = 114,287; 78.5%), Black (n = 6663; 4.6%), South Asian (n = 20,969; 14.4%) and Mixed/Other (n = 3637; 2.5%) ethnicities. Minor model adjustment was required to adjust for greater observed than predicted glycaemic responses to DPP4i (White-1.6 mmol/mol; Black-3.0 mmol/mol; South Asian-2.6 mmol/mol; Mixed/Other-2.6 mmol/mol). SGLT2i predictions did not require adjustment for non-White ethnicity groups. After model updates, average predict...