Reporter brief

Using propensity score-matched Medicare claims data (2014-2020), this real-world analysis compared adults aged ≥65 with type 2 diabetes who initiated empagliflozin versus dipeptidyl peptidase-4 inhibitors or GLP-1 receptor agonists. Empagliflozin was associated with lower rates of major adverse cardiovascular events (HR 0.77), hospitalization for heart failure (HR 0.72), and all-cause mortality (HR 0.66) versus DPP4 inhibitors, with consistent effects across sociodemographic subgroups but greater absolute benefits in those with prevalent cardiovascular disease.

Assessment pending; this report does not establish a change in evidence.

• —Limitations have not been recorded; consult the primary source.

Cohort; Human.

Adults aged ≥65 years with type 2 diabetes from Medicare claims data (2014-2020), propensity score-matched

Design

Cohort

Sample

—

Journal

Diabetes Care

Published

Sep 21, 2026

MACE: HR 0.77 (99.9% CI [0.69, 0.85]), IRD = -10.3 [-14.1, -6.4]; HHF vs DPP4is: HR 0.72 (CI [0.67, 0.79]), IRD = -18.3 [-22.9, -13.6]; ACM vs DPP4is: HR 0.66 (CI [0.57, 0.76]), IRD = -8.6 [-11.4, -5.8]; HHF vs GLP-1RAs: HR 0.88 (CI [0.81, 0.95]), IRD = -6.9 [-10.8, -3.1]

• —Assessment: Superseded.
• —Only the source material recorded on this evidence page was assessed.

Not recorded.

See the SGLT2 inhibitors timeline and recorded assessment for prior evidence.