SGLT2 Inhibitors Raise Hemoglobin and Hematocrit in Trial Meta-analysis

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been associated with higher hemoglobin and hematocrit in randomized trials, but the magnitude and importance of these changes have been uncertain. Researchers searched three databases through July 22, 2026, and pooled results from 85 randomized, double-masked trials comparing an SGLT2 inhibitor with placebo or an active comparator in people with cardiovascular disease, diabetes, heart failure, or chronic kidney disease. The trials included 70,543 participants and had a median duration of 24 weeks.

Compared with control, SGLT2 inhibitor use was associated with a 0.60 g/dL greater change in hemoglobin (95% CI, 0.55 to 0.66) and a 2.36-percentage-point greater change in hematocrit (95% CI, 2.19 to 2.52). Among secondary outcomes, erythropoietin increased by 2.11 mIU/mL more with treatment (95% CI, 0.5 to 3.71), while transferrin saturation decreased by 0.84 percentage points (95% CI, 0.47 to 1.21 lower).

The findings show consistent, statistically significant changes in blood and iron-related markers across trials. However, the authors said the clinical significance is unclear; the results do not establish that these changes improve or worsen clinical outcomes. The median follow-up was relatively short, and the analysis included both placebo-controlled and active-comparator trials.