A Systematic Review and Meta-analysis on the Safety and Efficacy of Sodium–Glucose Cotransporter 2 Inhibitor Use in Hospitalized Patients
Pooled result · KetoacidosisResult — go to the resultRate ratio 1.50 95 CI 0.56–4.23Authors' conclusion
SGLT2 inhibitor use among hospitalized patients was associated with numerically higher rates of ketoacidosis, although further studies are required.
Study context
- Population
- Patients hospitalized for any reason; RCTs: 29.5% with T2D
- Participants
- 19,846 patients23 RCTs
- Comparison
- SGLT2i vs placebo or active comparator
- Outcome
- Ketoacidosis
Methodological detailsrandom-effects meta-analysis, RCTs and cohort studies analysed separately, Ketoacidosis rates were low, likely limiting power to detect differences
- Random-effects meta-analysis
- RCTs and cohort studies analysed separately
- Ketoacidosis rates were low, likely limiting power to detect differences
Pooled result
As reported in the abstract
Rate ratio
1.50
95 CI 0.56–4.23
P = 0.38
By group
SGLT2i
0.210 per 100 person-years
CI 0.119–0.370
Control
0.140 per 100 person-years
CI 0.070–0.280
SGLT2ivs Control
rate ratio 1.50 (95 CI 0.56–4.23); P = 0.38
Further pooled results
| Outcome | OR | P value | |
|---|---|---|---|
| Readmissions and urgent visits, HF trialsSGLT2ivs ControlFewer with SGLT2i | 0.64 (95 CI 0.47–0.86) | P < 0.01 | |
| Mortality, HF trialsSGLT2ivs Control | 0.74 (95% CI 0.56–0.98) | P = 0.03 | |
| 0.512Odds ratio (log scale) |
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Acute kidney injury, all RCTsSGLT2ivs ControlLower incidence with SGLT2i | 0.76 (0.60–0.97) | P = 0.03 | |
| 0.512Odds ratio (log scale) |
Adverse events, observational studies
- 20 observational studies did not show increased adverse events
Original publication
A Systematic Review and Meta-analysis on the Safety and Efficacy of Sodium–Glucose Cotransporter 2 Inhibitor Use in Hospitalized Patients. Diabetes Care. Published 27 November 2024. doi:10.
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