Dipeptidyl peptidase-4 inhibitor use and risk of diabetic retinopathy: A population-based study

N. H. Kim, J. Choi, K. M. Choi, S. H. Baik, J. Lee, S. G. Kim

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    14 Citations (Scopus)


    Aims: This study examined whether dipeptidyl peptidase (DPP)-4 inhibitor use is beneficial or harmful to diabetic retinopathy (DR) compared with other glucose-lowering agents in patients with type 2 diabetes (T2D). Methods: From a population-based cohort provided by the National Health Insurance Service in Korea, 67,743 adults with T2D were identified as having been treated with oral glucose-lowering agents between 2008 and 2013. Matching (1:1) was performed for two groups comparing ever-use (cases) and never-use (controls) of DPP-4 inhibitors (n = 14,522 in each group). Cox regression analyses were used to assess risk of the following DR events: vitreous haemorrhage; vitrectomy or photocoagulation; intravitreal agent use; and blindness. Results: During a median follow-up of 28.4 (14.0–45.2) months, there were 305 (in controls) and 342 (in cases) composite DR events. DPP-4 inhibitor ever-use was not associated with overall risk of composite DR events [adjusted hazard ratio (HR): 1.08, 95% CI: 0.93–1.26] compared with never-use, nor was the risk of each DR outcome increased with DPP-4 inhibitor therapy either. However, DPP-4 inhibitor administration for < 12 months was associated with a greater risk of composite DR events (adjusted HR: 1.31, 95% CI: 1.09–1.57) compared with other glucose-lowering agents over the same treatment period. Conclusion: In comparison to other oral glucose-lowering agents, DPP-4 inhibitor treatment did not increase overall risk of DR. However, DPP-4 inhibitors may be associated with an increased risk of retinopathy events early in the treatment phase.

    Original languageEnglish
    Pages (from-to)361-367
    Number of pages7
    JournalDiabetes and Metabolism
    Issue number4
    Publication statusPublished - 2018 Sept


    • Diabetic retinopathy
    • Dipeptidyl peptidase-4 inhibitors
    • Type 2 diabetes

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Endocrinology


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