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Costco to start selling Medicare plans — here’s where it will be offered and what to know

·19 Aug
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Costco will provide Medicare Advantage plans and a Medicare supplemental plan

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The Independent

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Re: Renal outcomes in people with type 2 diabetes with and without albuminuria treated with SGLT-2 inhibitors and GLP-1 receptor agonists: target trial emulation

Agreement: I Agree Body: Dear Editor Turchin et al. conducted a prospective study to evaluate the risk of renal deterioration in people with type 2 diabetes, who were prescribed glucagon-like peptide-1 (GLP-1) receptor agonists or sodium-glucose contransporter-2 (SGLT-2) inhibitors as an additional drug (1). The authors paid special attention to the existence of albuminuria (albumin to creatinine ratio ≥30 mg/g). Compared with DPP-4 inhibitors, GLP-1 receptor agonists and SGLT-2 inhibitors significantly reduce the risk of deterioration of renal function in people with albuminuria. In contrast, there was no advantage of renal benefit in people without albuminuria. I present my comment. Lee et al. reported the difference in the ability of renal protection and survival in patients with type 2 diabetes, who received SGLT-2 inhibitors or GLP-1 receptor agonists (2). They concluded that SGLT-2 inhibitors presented lower risk in the progression to kidney replacement therapy than GLP-1 receptor agonists. This means that the choice from two therapies is important for preventing the risk of renal deterioration in patients with type 2 diabetes. In combination with existence of proteinuria, risk assessment should be conducted by separating SGLT-2 inhibitors or GLP-1 receptor agonists as an additional drug. References 1. Turchin A, Petito LC, Hegermiller E, et al. Renal outcomes in people with type 2 diabetes with and without albuminuria treated with SGLT-2 inhibitors and GLP-1 receptor agonists: target trial emulation. BMJ 2026;394:e100574. 2. Lee YC, Wu LC, Wu VC, et al. Comparative Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists and Sodium/Glucose Cotransporter 2 Inhibitors in Preventing Chronic Kidney Failure and Mortality in Patients With Type 2 Diabetes and CKD. Am J Kidney Dis 2025;86(3):301-313.e1. No competing Interests: Yes The following competing Interests: Electronic Publication Date: Tuesday, October 20, 2026 - 00:08 AI use: No, I have not used AI Highwire Comment Subject: Renal outcomes in people with type 2 diabetes with and without albuminuria treated with SGLT-2 inhibitors and GLP-1 receptor agonists: target trial emulation Workflow State: Released Full Title: Re: Renal outcomes in people with type 2 diabetes with and without albuminuria treated with SGLT-2 inhibitors and GLP-1 receptor agonists: target trial emulation Highwire Comment Response to: Renal outcomes in people with type 2 diabetes with and without albuminuria treated with SGLT-2 inhibitors and GLP-1 receptor agonists: target trial emulation Check this box if you would like your letter to appear anonymously:: Last Name: Kawada First name and middle initial: Tomoyuki Email: kawada@nms.ac.jp Address: 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan Occupation: Proressor Emeritus Affiliation: Nippon Medical School BMJ: Additional Article Info: Rapid response

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