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Glycemic Velocity and Early Retinal Microvascular Change With GLP-1RA Versus SGLT2i Initiation in Type 2 Diabetes (GLIDE)

NCT07723820 · Status: NOT_YET_RECRUITING · Type: OBSERVATIONAL · Enrollment: 126

Last updated 2026-07-24

No results posted yet for this study

Summary

The GLIDE study looks at how the small blood vessels of the eye respond during the first months of a new diabetes medicine. Two widely used classes of glucose-lowering drugs, GLP-1 receptor agonists and SGLT2 inhibitors, are compared in adults with type 2 diabetes who have no diabetic retinopathy or only early (mild) diabetic retinopathy.

When blood sugar (HbA1c) falls quickly after starting treatment, the retina can undergo a brief, temporary worsening before it stabilizes and benefits over the long term. This study asks whether it is the speed of that blood-sugar reduction, which we call "glycemic velocity," rather than the specific drug, that drives early changes in retinal and choroidal blood flow.

Participants are patients whose own physician has decided, independently of the study, to start one of these two drugs for the first time. The study does not choose, provide, or change any medicine; it adds only eye imaging, blood tests, and observation. Each participant is followed with specialized, non-invasive eye scans, optical coherence tomography angiography (OCT-A) and structural/choroidal OCT, together with HbA1c and other measurements, at the start of treatment and again over the following months.

The main measurement is the change, from the start of treatment to month 3, in the density of the tiny deep-layer capillaries at the center of the retina, measured on OCT-A. The study will test whether faster HbA1c reduction is linked to greater early change in these vessels and, using statistical mediation analysis, will estimate how much of any difference between the two drug groups is explained by glycemic velocity versus a direct drug effect.

If glycemic velocity, a factor physicians can influence by adjusting how quickly treatment is intensified, turns out to drive early retinal change, the findings could guide safer treatment strategies and help identify patients who need closer eye monitoring when starting these medicines.

Conditions

Interventions

DRUG

GLP-1 Receptor Agonists

First-ever GLP-1 receptor agonist initiated as routine clinical care; class and rate of titration are recorded but not controlled by the study. Mapped to Cohort 1.

DRUG

SGLT2 inhibitor

First-ever SGLT2 inhibitor initiated as routine clinical care; recorded but not controlled by the study. Mapped to Cohort 2.

Sponsors & Collaborators

  • Thammasat University Hospital

    collaborator OTHER

  • Thammasat University

    collaborator OTHER

  • Thammasart University Hospital

    lead OTHER

Principal Investigators

  • Kanokporn Sanpawithayakul, MD, MSc, PhD · Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2026-09-01
Primary Completion
2027-06-01
Completion
2027-09-01

Countries

  • Thailand

Study Locations

More Related Trials

Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07723820 on ClinicalTrials.gov