LivingGLP1
Descriptive only

Death by suicide

Type 2 diabetes (adults)

longest follow-upRecorded harmsDoses of a drug pooledHazard ratio (from event counts)
43
Randomized trials
26
Treatments
14,225
Participants
1
Events

In plain language

No network meta-analysis was fitted here. The protocol requires at least two trials forming a connected network; this outcome has 43 trials. The trial data below are shown as reported.

Network of trials

Each circle is a treatment; each line joins treatments that were randomized against each other in at least one trial.
DULA_SCEMPAGLIFLOZINEXENER_SCEXEN_SCGLIMEPIRIDEGLP1RE_SCIDEGLIRA_SCIGLARLIXI_SCINS_DEGLUDECINS_GLARGINEINS_LISPROINS_PREMIXLIRA_SCLIXI_SCLOTI_POMAZD_SCORFO_POOTHER_ACTIVE_basal_bolus_insulinPEGLOX_SCPLACEBOSEMA_POSEMA_SCSITAGLIPTINSTANDARD_CARETASP_SCTIRZ_SC
Node area shows participants; line width shows trials comparing two treatments directly. Blue: GLP-1 receptor agonist containing treatments; grey: comparators. Hover over or tab to a node or line for details.

Comparability of the trials

Checked across designs (the set of treatments each trial compares) for eligibility, outcome definition and assessment, and the baseline factors above. Flags point to possible intransitivity; notes describe variation that is not tied to design.
  • FlagEligibility, bmi entry range: a design requires bmi 50 or more while another admits only 35 or less
  • NoteOutcome assessment, time point: selected time points span 5 to 78.21 weeks
  • NoteOutcome assessment, analysis set: mixed: completers 1, full_analysis 2, modified_itt 3, other 4, randomized 4, safety 29
  • NoteOutcome assessment, definition: mixed: ADA 2018 level 2 (below 3.0 mmol/L); level 3 row zero in all arms 1, C-SSRS post baseline category 1, Grade 3, needing third party assistance 1, Hypoglycemia adverse event of special interest 1, hypoglycemia requiring medical assistance 1, minor: symptoms with glucose below 3 mmol/L, self treated or resolved 1, minor: symptoms with glucose below 3.0 mmol/L, self treated 1, not stated 21, plasma glucose 54 mg/dL or lower 1, Severe (ADA) or glucose confirmed below 3.1 mmol/L with symptoms 1, severe hypoglycemia 1, severe hypoglycemia needing assistance of another person 1, Severe hypoglycemia needing assistance with glucose below 36 mg/dL or prompt recovery 1, Severe hypoglycemia requiring assistance of another person 1, severe hypoglycemia requiring third party assistance 1, severe symptomatic hypoglycemia needing assistance 1, severe symptomatic hypoglycemia needing assistance of another person, glucose below 2.0 mmol/L or prompt recovery 1, severe, requiring assistance of another person 2, symptomatic hypoglycemia confirmed below 3.3 mmol/L 1, symptomatic mild hypoglycemia, no glucose threshold printed 1, TEAE leading to death 1, Zero implied by no hypoglycemia episodes of any kind 1
  • NoteOutcome assessment, adjudicated: mixed: not stated 42, yes 1
  • NoteOutcome assessment, proportion method: mixed: not stated 41, observed 2
  • NoteOutcome assessment, intercurrent events (discontinuation): mixed: not stated 42, while_on_treatment 1
  • NoteOutcome assessment, intercurrent events (rescue): mixed: not stated 42, treatment_policy 1
  • NoteRisk of bias, blinding: mixed: double_blind 25, open_label 16, single_blind 2
  • NoteRisk of bias, funding: mixed: industry 36, mixed 4, non_industry 3
  • NoteData handling, input conversions: arms_combined 15, printed_denominator 7
Comparability items per trial
Trialtime weeksanalysis setdefinitioninstrumentadjudicatedproportion methodintercurrent events (discontinuation)intercurrent events (rescue)blindingfundingstart yearEligibility
NCT0313168730safetysevere hypoglycemia needing assistance of another personnot statednot statednot statednot statednot stateddouble_blindindustry2017age 18 to 75; T2D at least 6 months; HbA1c 7.0 to 10.5%; BMI 23 to 50; diet and exercise or metformin
NCT0232596016safetynot statednot statednot statednot statednot statednot statedopen_labelmixed2015age 18 to 70; BMI 24 or more; HbA1c 7.0 to 10.0 percent; metformin 1.5 g/day or more
PIONEER 457safetynot statednot statednot statednot statednot statednot stateddouble_blindindustry2016Age 18 or older; T2D on metformin with or without SGLT2i; HbA1c 7.0 to 9.5 percent; eGFR 60 or more
MAGNA VICTORIA26safetynot statednot statednot statednot statednot statednot stateddouble_blindmixed2015South Asian descent; age 18 to 74; BMI 23 or more; HbA1c 6.5 to 11.0 percent
Lixilan-O-AP24.43safetynot statednot statednot statednot statednot statednot statedopen_labelindustry2019adults with T2D on metformin with or without a second OAD; HbA1c 7.5 to 11 percent, or 7 to 10 percent with a non SGLT2i second OAD
PIONEER 1057safetynot statednot statedyesnot statedwhile_on_treatmenttreatment_policysingle_blindindustry2017Japanese adults 20 or older; T2D; HbA1c 7.0 to 10.5 percent on one oral glucose lowering drug
NCT0076581730full_analysisminor: symptoms with glucose below 3 mmol/L, self treated or resolvednot statednot statednot statednot statednot stateddouble_blindindustry2008adults 18 or older; insulin glargine 20 U/d or more alone or with metformin or pioglitazone; HbA1c 7.1 to 10.5 percent; BMI 45 or less
NCT0557997728safetyC-SSRS post baseline categorynot statednot statednot statednot statednot stateddouble_blindindustry2022age 18 to 75; T2D cohort on metformin, HbA1c 7.0 to 10.0, BMI 23 or more; obesity cohort BMI 30 or more without diabetes
GETGOAL-L-ASIA24safetysevere symptomatic hypoglycemia needing assistancenot statednot statednot statednot statednot stateddouble_blindindustry2009age 25 to 81; type 2 diabetes at least 1 year; stable basal insulin at least 10 U/day with or without sulfonylurea; HbA1c 7 to 10 percent
NCT0395175332safetynot statednot statednot statednot statednot statednot stateddouble_blindindustry2019age 20 to 74; BMI 25 to 45; metformin with or without one other oral agent
NCT0096066130otherminor: symptoms with glucose below 3.0 mmol/L, self treatednot statednot statedobservednot statednot statedopen_labelindustry2009age 18 or older; T2D on insulin glargine and metformin with or without sulfonylurea; HbA1c 7.0 to 10.0; BMI 25.0 (23.0 in South Korea) to 45.0; HbA1c above 7.0 after optimization
NCT0057782424full_analysisSevere hypoglycemia requiring assistance of another personnot statednot statednot statednot statednot stateddouble_blindindustry2008age 20 to 75; HbA1c 7.0 to 10.0 percent JDS; weight 50 kg or more; sulfonylurea based oral therapy
GetGoal-Duo124safetysymptomatic hypoglycemia confirmed below 3.3 mmol/Lnot statednot statedobservednot statednot stateddouble_blindindustry2009T2D on metformin 1.5 g or more with or without SU, glinide or TZD, HbA1c 7 to 10, BMI over 20; HbA1c 7 to 9 after run in
NCT0155827152safetynot statednot statednot statednot statednot statednot stateddouble_blindindustry2012Japanese; age 20 or more; BMI 18.5 to 35; HbA1c 7.0 to 10.0 percent; OAM naive or OAM stopped
AWARD-CHN126safetysevere, requiring assistance of another personnot statednot statednot statednot statednot stateddouble_blindindustry2012age 18 or older; BMI 19 to 35 kg/m2; HbA1c 7.0 to 10.5 percent OAM naive or 6.5 to 10.0 percent on OAM monotherapy
AWARD-824modified_ittnot statednot statednot statednot statednot statednot stateddouble_blindindustry2013age 18 or older; BMI up to 45; HbA1c 7.5 to 9.5 percent on sulfonylurea at least half maximal dose
LixiLan-G26safetynot statednot statednot statednot statednot statednot statedopen_labelindustry2016T2D 1 year or more; HbA1c 7 to 9 percent; BMI over 20 to 40; maximum tolerated GLP-1 RA plus metformin
SUSTAIN35safetySevere (ADA) or glucose confirmed below 3.1 mmol/L with symptomsnot statednot statednot statednot statednot stateddouble_blindindustry2017Adults 18 or older, HbA1c 7.0 to 10.5 percent on metformin monotherapy, eGFR 60 or more
AWARD-CHN252safetysevere, requiring assistance of another personnot statednot statednot statednot statednot statedopen_labelindustry2012age 18 or older; BMI 19 to 35 kg/m2; HbA1c 7.0 to 11.0 percent on metformin and/or sulfonylurea
NCT0221206717randomizednot statednot statednot statednot statednot statednot stateddouble_blindindustry2014age 18 to 64; HbA1c 6.5 to 9.0 percent; BMI 20 to 35; diet and exercise or metformin
NCT0074492624safetysevere hypoglycemianot statednot statednot statednot statednot stateddouble_blindindustry2008age 18 to 80; drug naive; HbA1c 6.5 to 10 percent; BMI 25 to 45
ELEGANT26randomizedGrade 3, needing third party assistancenot statednot statednot statednot statednot statedopen_labelindustry2012age 18 to 75; BMI 25 or more; HbA1c 6.5 to 8.5 percent; insulin 3 to 16 months with 4 percent weight gain
PIONEER 1131safetyADA 2018 level 2 (below 3.0 mmol/L); level 3 row zero in all armsnot statednot statednot statednot statednot stateddouble_blindindustry2019age 18 or older; HbA1c 7.0 to 10.0 percent at screening, 7.0 to 9.5 at randomization; no glucose lowering drugs; eGFR 60 or more
SUSTAIN™ 535safetynot statednot statednot statednot statednot statednot stateddouble_blindindustry2014age 18 or older (20 in Japan); HbA1c 7.0 to 10.0 percent; stable basal insulin with or without metformin; eGFR 30 or more
DUAL™ I Japan53safetynot statednot statednot statednot statednot statednot statedopen_labelindustry2015Japanese adults 20 or older; HbA1c 7.0 to 11.0 percent; BMI at least 20; insulin naive on one oral drug
NCT0508644514safetyHypoglycemia adverse event of special interestnot statednot statednot statednot statednot stateddouble_blindindustry2021Japanese; age 20 to 70; BMI 20 to 35; HbA1c 7.0 to 10.0 diet only or 6.5 to 9.0 on one OAM, withdrawn 28 days
LIXILAN JP-O152.43safetyTEAE leading to deathnot statednot statednot statednot statednot statedopen_labelindustry2016insulin naive Japanese adults; HbA1c 7.5 to 10%; FPG 13.8 mmol/L or less; one or two OADs
NCT0288762578.21othersevere hypoglycemia requiring third party assistancenot statednot statednot statednot statednot statedopen_labelmixed2015age 18 to 75; HbA1c above 7.5 percent on near maximal metformin plus sulfonylurea
SUSTAIN™35safetynot statednot statednot statednot statednot statednot statedopen_labelindustry2014Japanese; age 20 or older; HbA1c 6.5 to 9.5 percent on one OAD or 7.0 to 10.5 percent on diet and exercise
NCT0228827314modified_ittnot statednot statednot statednot statednot statednot stateddouble_blindindustry2014age 18 to 75; T2D on metformin 1500 mg or more; HbA1c 7.0 to 10.0 percent; BMI 45 or less
Lixilan-L-CN30.43safetynot statednot statednot statednot statednot statednot statedopen_labelindustry2019Chinese adults; HbA1c 7.0 to 10.5 percent; basal insulin 10 to 25 U/day with up to 2 oral drugs; FPG at most 8.9 mmol/L
GETGOAL-M24safetysevere symptomatic hypoglycemia needing assistance of another person, glucose below 2.0 mmol/L or prompt recoverynot statednot statednot statednot statednot stateddouble_blindindustry2008type 2 diabetes on metformin 1.5 g/day or more for 3 months; HbA1c 7 to 10 percent; FPG 13.9 mmol/L or less
NCT0145544116completersZero implied by no hypoglycemia episodes of any kindnot statednot statednot statednot statednot stateddouble_blindindustry2011age over 18; HbA1c 7 to 11 percent; BMI over 25; diet or metformin; sedentary
NCT0331172416modified_ittplasma glucose 54 mg/dL or lowernot statednot statednot statednot statednot stateddouble_blindindustry2017age 18 to 75; T2D at least 6 months; HbA1c 7.0 to 10.5%; BMI 23 to 45; diet or stable metformin
NCT0446690420safetynot statednot statednot statednot statednot statednot stateddouble_blindindustry2020age 18 to 75; T2D on diet and exercise or stable metformin; HbA1c 7.5 to 11.0 percent; BMI 20 to 35
NCT0070081752othernot statednot statednot statednot statednot statednot statedopen_labelindustry2008age 18 to 80; HbA1c 7.5 to 10%; BMI 45 or less; metformin 1500 mg/day or more for 3 months
S00285824randomizednot statednot statednot statednot statednot statednot stateddouble_blindindustryT2D age over 35; clinical CKD; eGFR above 30 mL/min; stable ACE inhibitor or ARB
S00288512othersymptomatic mild hypoglycemia, no glucose threshold printednot statednot statednot statednot statednot statedopen_labelnon_industry2019age 20 to 75; HbA1c 7.0 or more on metformin and glimepiride; eGFR 30 or more
S00292824safetynot statednot statednot statednot statednot statednot statedsingle_blindnon_industry2022age 18 to 65; BMI 50 or more; type 2 diabetes
S00298424randomizednot statednot statednot statednot statednot statednot statedopen_labelmixed2020T2D age 45 or older; HbA1c 7.0 to 11.0 percent; metformin at least 3 months
S00299226.43safetynot statednot statednot statednot statednot statednot statedopen_labelindustryadults 18 or older; HbA1c 7.5 to 10 percent; BMI 20 to less than 40; basal insulin 20 to 50 U plus metformin with or without SGLT2i
S0030476.57safetySevere hypoglycemia needing assistance with glucose below 36 mg/dL or prompt recoverynot statednot statednot statednot statednot stateddouble_blindindustry2006age 20 to 75; HbA1c 7.0 to 10.0 percent; BMI 35 or less; sulfonylurea with or without metformin
S0030795safetyhypoglycemia requiring medical assistancenot statednot statednot statednot statednot statedopen_labelnon_industry2010age 18 to 80, HbA1c 7.5 to 12 percent, BMI 21 to 35, T2D at least 6 months

Trial data

What each trial contributes. Arm rows give the arm value with its standard error, or events over participants; contrast rows give the hazard ratio (from event counts) on the analysis scale (log) against the trial's first row. Flags mark converted, combined or approximated inputs.
Trial data entering this analysis
TrialArmTreatmentWeekDataValueSEEvents / NFlagsSource
NCT03131687A1PLACEBO30arm, events0 / 51R0016215:Table 3
NCT03131687A2+A3+A4+A5TIRZ_SC30arm, events0 / 213arms_combinedR0016215:Table 3
NCT03131687A6DULA_SC30arm, events0 / 54R0016215:Table 3
NCT02325960A1EXEN_SC16arm, events0 / 22R0024438:Results
NCT02325960A2INS_GLARGINE16arm, events0 / 23R0024438:Results
PIONEER 4A1SEMA_PO57arm, events0 / 285R0015836:Supplement Table S6
PIONEER 4A2LIRA_SC57arm, events0 / 284R0015836:Supplement Table S6
PIONEER 4A3PLACEBO57arm, events0 / 142R0015836:Supplement Table S6
MAGNA VICTORIAA1LIRA_SC26arm, events0 / 22R0020542:Results
MAGNA VICTORIAA2PLACEBO26arm, events0 / 25R0020542:Results
Lixilan-O-APA1IGLARLIXI_SC24.43arm, events0 / 351R0013321:Results
Lixilan-O-APA2INS_GLARGINE24.43arm, events0 / 350R0013321:Results
Lixilan-O-APA3LIXI_SC24.43arm, events0 / 177R0013321:Results
PIONEER 10A1+A2+A3SEMA_PO57arm, events0 / 393arms_combinedR0018421:Table 2
PIONEER 10A4DULA_SC57arm, events0 / 65R0018421:Table 2
NCT00765817A1EXEN_SC30arm, events0 / 138R0027069:Table 3
NCT00765817A2PLACEBO30arm, events0 / 123R0027069:Results
NCT05579977A10+A11+A12+A13+A9LOTI_PO28arm, events0 / 325arms_combinedregistry:outcomes
NCT05579977A8PLACEBO28arm, events0 / 64registry:outcomes
GETGOAL-L-ASIAA1LIXI_SC24arm, events0 / 154R0022626:Results
GETGOAL-L-ASIAA2PLACEBO24arm, events1 / 157R0022626:Results
NCT03951753A1TIRZ_SC32arm, events0 / 45registry:adverse_events
NCT03951753A2SEMA_SC32arm, events0 / 44registry:adverse_events
NCT03951753A3PLACEBO32arm, events0 / 28registry:adverse_events
NCT00960661A1EXEN_SC30arm, events0 / 316R0016788:Results
NCT00960661A2INS_LISPRO30arm, events0 / 321R0016788:Figure 1
NCT00577824A1PLACEBO24arm, events0 / 36R0018881:Results
NCT00577824A2+A3EXEN_SC24arm, events0 / 145arms_combinedR0018881:Results
GetGoal-Duo1A1PLACEBO24arm, events0 / 223R0026107:Results
GetGoal-Duo1A2LIXI_SC24arm, events0 / 223R0026107:Results
NCT01558271A1DULA_SC52arm, events0 / 281R0011754:Table 2
NCT01558271A2LIRA_SC52arm, events0 / 141R0011754:Table 2
AWARD-CHN1A1DULA_SC26arm, events0 / 244R0014229:Table 2
AWARD-CHN1A3GLIMEPIRIDE26arm, events0 / 245R0014229:Table 2
AWARD-8A1DULA_SC24arm, events0 / 240R0016038:Results
AWARD-8A2PLACEBO24arm, events0 / 60R0016038:Results
LixiLan-GA1IGLARLIXI_SC26arm, events0 / 257registry:adverse_events
LixiLan-GA2GLP1RE_SC26arm, events0 / 257registry:adverse_events
SUSTAINA1SEMA_SC35arm, events0 / 288R0014802:Results
SUSTAINA3SITAGLIPTIN35arm, events0 / 290R0014802:Table 3
AWARD-CHN2A2DULA_SC52arm, events0 / 257R0023722:Table 2
AWARD-CHN2A3INS_GLARGINE52arm, events0 / 259R0023722:Table 2
NCT02212067A1SEMA_SC17arm, events0 / 37R0021892:Supplement Table 2
NCT02212067A2PLACEBO17arm, events0 / 38R0021892:Supplement Table 2
NCT00744926A1PLACEBO24arm, events0 / 123printed_denominatorR0025346:Results
NCT00744926A2+A3TASP_SC24arm, events0 / 245printed_denominator;arms_combinedR0025346:Results
ELEGANTA1LIRA_SC26arm, events0 / 26R0025175:Results
ELEGANTA2STANDARD_CARE26arm, events0 / 24R0025175:Results
PIONEER 11A1+A2+A3SEMA_PO31arm, events0 / 390arms_combinedR0019663:Table 3
PIONEER 11A4PLACEBO31arm, events0 / 131R0019663:Table 3
SUSTAIN™ 5A1+A2SEMA_SC35arm, events0 / 264arms_combinedR0012671:Table 2
SUSTAIN™ 5A3PLACEBO35arm, events0 / 133R0012671:Table 2
DUAL™ I JapanA1IDEGLIRA_SC53arm, events0 / 275registry:adverse_events
DUAL™ I JapanA2INS_DEGLUDEC53arm, events0 / 271registry:adverse_events
DUAL™ I JapanA3LIRA_SC53arm, events0 / 273registry:adverse_events
NCT05086445A1PLACEBO14arm, events0 / 11R0003844:Table 2
NCT05086445A2+A3+A4ORFO_PO14arm, events0 / 49arms_combinedR0003844:Table 2
LIXILAN JP-O1A1IGLARLIXI_SC52.43arm, events0 / 161R0015751:Table 3
LIXILAN JP-O1A2LIXI_SC52.43arm, events0 / 160R0015751:Results
NCT02887625A1EXENER_SC78.21arm, events0 / 129R0026120:Supplementary Table 1
NCT02887625A2OTHER_ACTIVE_basal_bolus_insulin78.21arm, events0 / 122R0026120:Supplementary Table 1
SUSTAIN™A1+A2SEMA_SC35arm, events0 / 205arms_combinedR0014736:Table 2
SUSTAIN™A3SITAGLIPTIN35arm, events0 / 103R0014736:Table 2
NCT02288273A1EXENER_SC14arm, events0 / 61R0025397:Results
NCT02288273A2PLACEBO14arm, events0 / 56R0025397:Results
Lixilan-L-CNA1IGLARLIXI_SC30.43arm, events0 / 212R0014540:Table 3
Lixilan-L-CNA2INS_GLARGINE30.43arm, events0 / 214R0014540:Table 3
GETGOAL-MA1+A2LIXI_SC24arm, events0 / 510arms_combinedR0025872:Table 2
GETGOAL-MA3PLACEBO24arm, events0 / 170printed_denominatorR0025872:Table 2
NCT01455441A1LIRA_SC16arm, events0 / 18R0010221:Results
NCT01455441A2PLACEBO16arm, events0 / 16R0010221:Results
NCT03311724A1PLACEBO16arm, events0 / 26R0010282:Table 2
NCT03311724A2+A3+A4TIRZ_SC16arm, events0 / 85arms_combinedR0010282:Table 2
NCT04466904A2+A3MAZD_SC20arm, events0 / 16arms_combinedR0009340:Table 2
NCT04466904A4DULA_SC20arm, events0 / 6printed_denominatorR0009340:Table 2
NCT04466904A5PLACEBO20arm, events0 / 12printed_denominatorR0009340:Table 2
NCT00700817A1+A2LIRA_SC52arm, events0 / 446arms_combinedR0024199:Table 2
NCT00700817A3SITAGLIPTIN52arm, events0 / 219R0024199:Table 2
S002858A1LIXI_SC24arm, events0 / 51R0001573:Supplement Table S2
S002858A2PLACEBO24arm, events0 / 50R0001573:Supplement Table S2
S002885A1DULA_SC12arm, events0 / 13R0003420:Results
S002885A2EMPAGLIFLOZIN12arm, events0 / 12R0003420:Results
S002928A1PLACEBO24arm, events0 / 41R0007034:Results
S002928A2+A3PEGLOX_SC24arm, events0 / 82arms_combinedR0007034:Results
S002984A1PEGLOX_SC24arm, events0 / 39R0011969:Supplement Table S2
S002984A2INS_GLARGINE24arm, events0 / 39R0011969:Supplement Table S2
S002992A1IGLARLIXI_SC26.43arm, events0 / 443R0010673:Results
S002992A2INS_PREMIX26.43arm, events0 / 444R0010673:Results
S003047A1+A2LIXI_SC6.57arm, events0 / 80printed_denominator;arms_combinedR0016337:Results
S003047A3PLACEBO6.57arm, events0 / 40printed_denominatorR0016337:Results
S003079A1EXEN_SC5arm, events0 / 18R0025923:Results
S003079A2STANDARD_CARE5arm, events0 / 18R0025923:Results

Rerun this analysis yourself

Remove treatments or trials and refit the frequentist and Bayesian models in your browser, with the same methods as the published analysis.

Open in the NMA lab