Comparative analysis of serious adverse effects of antidiabetic drugs and complications associated with type II diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a major global health problem for which a wide range of antidiabetic medications are available. Adverse effects of antidiabetic medications may negatively affect patients’ health and treatment adherence. In Egypt, limited data are available regarding the adverse-effect profiles of antidiabetic agents. This study aimed to compare safety profiles, treatment-related adverse effects, and diabetes-related complications associated with commonly prescribed antidiabetic medications. A multicenter, cross-sectional observational study was conducted across diabetes outpatient clinics in Egypt from February 2024 to May 2024. Adult patients with type 2 diabetes on antidiabetic regimens were enrolled. Data was collected through medical records and patient interviews, including demographics, clinical history, laboratory results, diabetes complications, and treatment-related adverse events. Univariate logistic regression analyses were performed to assess the associations between antidiabetic medications and diabetes-related complications and adverse outcomes. Unadjusted odds ratios (ORs) with 95% confidence intervals were reported. Statistical significance was set at p-value ≤ 0.05. Several statistically significant associations were observed between the use of different antidiabetic medications and the prevalance of side effects and diabetes-related complications. Among 1,534 participants, insulin was associated with increased odds of cardiovascular, renal, and peripheral complications. Metformin, liraglutide, and empagliflozin were linked to gastrointestinal issues. Various mental disorders were notably associated with insulin. Empagliflozin and sitagliptin showed higher infection risks, while insulin and sulphonylureas were linked to some organ damage and retinopathy. Understanding the safety profiles of antidiabetic drugs is essential for optimizing treatment. The observed associations may help inform clinical decision-making and improve patient outcomes. However, they should be interpreted as associations rather than causal relationships and warrant further investigation in well-designed prospective studies.