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The present study emulated a target trial to avoid immortal time and selection bias, chose a second-line glucose-lowering therapy as an active comparator to reduce confounding by indication, used an outcome definition based only on primary care records to minimize detection bias due to differential hospitalizations, and implemented a lag time to mitigate bias due to reverse causality

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For example, Zepbound is contraindicated for people with a personal or family history of medullary thyroid carcinoma or MEN2

Efficacy and safety of sitagliptin versus glipizide in patients with type 2 diabetes and moderate-to-severe chronic renal insufficiency