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# SGLT-2 inhibitors show higher adherence and persistence than GLP-1 RAs in type 2 diabetes
- URL: https://www.coios.me/sglt-2-inhibitors-show-higher-adherence-and-persistence/
- Published: 2026-10-31T11:15:56.000Z
- Updated: 2026-11-01T07:06:41.000Z
- Description: SGLT-2 inhibitors had higher adherence and persistence than GLP-1 receptor agonists in 14,998 matched patients, most clearly with cardiovascular disease.
- Author: Daniel Ryan
- Tags: Behavioural science, Adherence and persistence, Obesity, diabetes and GLP-1, #peer-reviewed, #refines, #item, #source-2026-10, #score-65

This study compared adherence and persistence with SGLT-2 inhibitors and GLP-1 receptor agonists in type 2 diabetes. It used pharmacy claims from Castilla y León, Spain, on 14,998 propensity-matched new users aged 40 or over, 2019–2024\. One-year adherence by medication possession ratio was 86.66% with SGLT-2 inhibitors and 76.53% with GLP-1 receptor agonists (OR 2.02). Persistence at 12 months was 71.48% versus 66.52% (HR for discontinuation 0.83). In matched patients with cardiovascular disease, the gap widened: OR 2.44 for adherence and HR 0.66 for discontinuation. Patients with fewer than two refills were excluded, and deaths, side effects and clinical outcomes were not recorded.

*Why it is interesting: Both classes are recommended for people with diabetes and cardiovascular disease, yet direct comparisons of medication-taking are few. The gap was widest in that group, and oral semaglutide made up about half of GLP-1 receptor agonist use.*

Source

[Pharmaceuticals, 27 October 2026](https://doi.org/10.3390/ph19101607?ref=coios.me)

Paper

SGLT-2 Inhibitors Versus GLP-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus: A Propensity Score-Matched Cohort Study Comparing Adherence and Persistence with Specific Reference to Cardiovascular Disease

Authors

González-González MA, Pedrosa-Naudín MA, Fernández-Lázaro D, Díaz Planelles I, Álvarez FJ, Gutiérrez-Abejón E

DOI

10.3390/ph19101607

Full text

[Open copy](https://pmc.ncbi.nlm.nih.gov/articles/PMC13708738/?ref=coios.me) (open-access copy, PubMed Central)

Type

Peer-reviewed article

Design

Retrospective propensity score-matched cohort of pharmacy claims, adults 40+ with T2DM initiating SGLT-2i or GLP-1 RA, 2019-2024; 12-month adherence (MPR) and persistence (60-day gap)

Verdict

Refines prior evidence

Driver

[Adherence and persistence](https://www.coios.me/d-adherence/)

Driver

[Obesity, diabetes and GLP-1](https://www.coios.me/d-obesity-diabetes/)

Free full text

[Free to read at the publisher](https://doi.org/10.3390/ph19101607?ref=coios.me)

Abstract — the authors' own words, CC BY

Background/Objectives : Poor adherence and persistence to sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a critical issue in the treatment of type 2 diabetes mellitus (T2DM), especially in patients with cardiovascular disease (CVD). We aimed to compare adherence and persistence to these drugs in routine care. Methods : A retrospective propensity score-matched (PSM) cohort study was conducted using pharmacy claims data. Patients aged 40 years or older with T2DM initiating SGLT-2is or GLP-1 RAs from 1 January 2019 to 31 December 2024 were included. Adherence was measured using the Medication Possession Ratio (MPR), and persistence was defined as the time to discontinuation (gap ≥ 60 days between refills). Results : At the 1-year follow-up, the SGLT-2i cohort showed significantly higher adherence compared to the GLP-1 RA cohort (86.66% vs. 76.53%; OR = 2.02) and higher persistence (71.48% vs. 66.52% at 12 months; HR = 0.83). The main factors associated with lack of persistency were newly diagnosed T2DM (HR = 1.25) and insulin use (HR = 1.32). In the CVD subgroup, the differences in favor of the SGLT-2i cohort were more pronounced for adherence (89.57% vs. 78.12%; OR = 2.44) and persistence (73.9% vs. 63.59%; HR = 0.66). Conclusions : In real-world clinical practice, adherence and persistence rates were higher in patients on SGLT-2is compared to those on GLP-1 RAs, particularly in the CVD subgroup. Our findings suggest that the new strategies are necessary to improve adherence and persistence to these medications, particularly in patients with CVD.