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Clinical Summary

Do SGLT2 Inhibitors Protect Against Hyperkalaemia in Patients With Type 2 Diabetes?


  • In patients with type 2 diabetes mellitus (T2DM), the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors significantly reduced the risk of developing a hyperkalaemia event but did not reduce the serum-potassium level.

Why This Matters

  • There has been uncertainty over whether SGLT2 inhibitors cause hyperkalaemia or protect against it.

Study Design

  • Researchers at University of Surrey and King's College National Health Service Foundation Trust conducted a meta-analysis of nine studies, identified after a search across electronic databases.
  • Primary outcomes: change in serum-potassium levels from baseline and number of hyperkalaemia events.
  • Funding: None.

Key Results

  • SGLT2 inhibitors vs placebo group had a significant reduction in the risk of hyperkalaemia events (OR 0.72; 95% CI 0.61 to 0.85; P<0.001).
  • SGLT2 inhibitors did not show any significant effects on serum-potassium level (mean difference -0.04 mmoL/L; 95% CI -0.08 to 0.00 mmoL/L; I2 89%; P=0.04).


  • Heterogeneity among studies.