SGLT2 Inhibitors Reduce Cardiorenal Outcomes in Type 2 Diabetes Meta-Analysis

A meta-analysis published in Diabetes, Obesity and Metabolism assessed cardiovascular and kidney outcomes with sodium–glucose cotransporter-2 (SGLT2) inhibitors in adults with type 2 diabetes. Investigators searched four databases through 15 May 2026, including large placebo-controlled randomized trials and prespecified subgroup analyses. Fourteen studies included 76,969 patients: 41,761 receiving SGLT2 inhibitors and 35,208 receiving placebo. The primary endpoint was first hospitalization for heart failure or cardiovascular death.

SGLT2 inhibitors reduced the primary endpoint hazard by 23% (HR 0.77, 95% CI 0.73–0.81), with no detected heterogeneity or effect modification by baseline heart failure or established atherosclerotic cardiovascular disease. Major adverse cardiovascular events were reduced by 14% (HR 0.86, 95% CI 0.81–0.92). Cardiovascular death and myocardial infarction were significantly reduced, but stroke was not (HR 0.93, 95% CI 0.81–1.08). First heart failure hospitalization fell by 29% (HR 0.71, 95% CI 0.66–0.77), and composite kidney outcomes by 31% (HR 0.69, 95% CI 0.60–0.79).

These findings support the cardiorenal benefits of SGLT2 inhibitors in type 2 diabetes. However, kidney outcomes showed moderate heterogeneity and used nonstandardized definitions. The authors also caution that the ertugliflozin estimate requires interpretation in light of trial-level clinical differences. Only the abstract was available; absolute event rates and safety findings were not provided, limiting assessment of absolute benefit and benefit–risk balance.