Nobody has measured it. Every published comparison sets one diabetes drug against another. None follows an untreated group. The best evidence is a 358,203-pair cohort. In it, stones ran at 21.3 per 1,000 person-years on a GLP-1 and 14.9 on an SGLT2 inhibitor [1]. That ranks two treatments. It does not price either against taking nothing, which is the same limit this site reads into the glaucoma comparison.
What the cohort measured
Adults with commercial insurance were matched on starting either drug class. Median follow-up was 192 days. Nephrolithiasis came in at a hazard ratio of 0.69 (95% CI 0.67 to 0.72) for the SGLT2 arm. The rate difference was 6.4 fewer events per 1,000 person-years.
A second comparison, against DPP4 inhibitors, ran 14.6 against 19.9 per 1,000 person-years. The hazard ratio there was 0.74 (95% CI 0.71 to 0.77). The association held across sex, race and ethnicity, chronic kidney disease history and obesity.
Age changed it. Under 70 the reduction was larger. At 70 and over the hazard ratio was 0.85. A pooled figure describes nobody in particular.
The direction of the claim
This is a study about SGLT2 inhibitors. GLP-1 drugs are the yardstick, not the subject. What it supports is that SGLT2 use came with fewer stones than GLP-1 use. Reading it backwards turns a ranking into a risk estimate, which is the error set out in the gout comparison.
What weight loss does to urate
GLP-1 drugs lower uric acid as well, by a different route. In a post hoc analysis of SURMOUNT-1, serum uric acid fell 0.69, 0.92 and 0.95 mg/dL on the three tirzepatide doses [3]. Placebo gave 0.18 mg/dL. A mediation analysis attributed 72.7% of the fall to weight loss.
Weight loss is slower than a diuretic effect. Nothing in the 192-day cohort window would capture much of it. The two classes may therefore look further apart at six months than at three years. It is the same follow-up problem raised in the uric acid analysis.
What would settle it
A cohort with an untreated arm, followed for years rather than months. The kidney trials already run that long. FLOW followed people with chronic kidney disease and stopped early for benefit [4], and stones were not among its endpoints.
Until somebody counts them, the honest answer stands: unmeasured. If stones are part of your history, put it in the intake. Whether a seller makes a clinician reachable is a separate question. Most publish nothing about it. what sellers do not publish counts how little. The list worth sending is in questions they leave open.