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Clinical Summary

SGLT2i Offers CV, Renal, and Survival Benefits for those with Type 2 Diabetes


  • The use of sodium-glucose co-transporter-2 inhibitor (SGLT2i) was associated with a reduced risk of the composite cardiovascular (CV) outcomes, severe renal disease, and all-cause mortality in patients with type 2 diabetes (T2D) who received metformin.
  • The CV benefit was mainly driven by a reduced risk of ischaemic stroke.

Why This Matters

  • Findings confirm that the benefits of SGLT2i in patients with T2D are applicable to populations at low CV risk in real-world settings, which supports an increasing role of SGLT2i in diabetes care.

Study Design

  • This population-based cohort study included 12 978 patients with T2D who received SGLT2i and 44 286 matched patients who did not receive SGLT2i, identified from the UK IQVIA Medical Research Data (2013-2018).
  • Main outcomes: composite CV outcomes (non-fatal myocardial infarction/ischaemic stroke requiring hospitalisation and CV death), severe renal disease, and all-cause mortality.
  • Funding: Bayer.

Key Results

  • SGLT2i users vs non-users had a significantly lower risk of the (adjusted HR [aHR]; 95% CI):
    • composite CV composite (0.75; 0.61 to 0.93; P=0.01);
    • severe renal disease (0.55; 0.46 to 0.67; P<0.01); and
    • all-cause mortality (0.56; 0.49 to 0.63; P<0.01).
  • The risk reductions were similar irrespective of baseline chronic kidney disease (CKD).
  • SGLT2i users vs non-users had a significant reduction in the risk of ischaemic stroke (aHR 0.51; 95% CI 0.36 to 0.74; P<0.01) but not MI (aHR 0.98; 95% CI 0.74 to 1.28; P=0.86).


  • Retrospective design.