Glycemic and Renal Effects of SGLT2 Inhibitors in Monogenic Diabetes: A Real‐World National Study
Authors' conclusion
In this nationwide cohort of patients with monogenic diabetes-the largest reported to date-SGLT2i therapy was associated with improved glycemic control in individuals with baseline HbA1c ≥ 8%, reduced albuminuria, and showed a favourable safety profile.
Study context
- Population
- Adults with genetically confirmed monogenic diabetes treated with SGLT2i; mean age 48.6 ± 15.2 years
- Participants
- 40 adults
- Exposure
- MIDD vs HNF1B-MODY vs HNF1A/HNF4A-MODY vs Other MODY subtypes
- MIDDn = 16
- HNF1B-MODYn = 9
- HNF1A/HNF4A-MODYn = 11
- Other MODY subtypesn = 4
- Outcome
- HbA1c
- Follow-up
- 23.9 ± 5.9 months
Methodological detailsmulticenter, real-world, nationwide
- Multicenter
- Real-world
- Nationwide
Main finding
As reported in the abstract
- HbA1c in patients with baseline HbA1c ≥ 8%: decreased from 9.6% ± 1.3% to 7.6% ± 0.7%
- p = 0.001
Observational data: associations, not effects.
Further findings
UACR change · 1 and 2 years
- UACR change at 1 year
- −35.6%
- UACR change at 2 years
- −43.5%
- UACR decline (p)
- P = 0.004
- Decline particularly in those with baseline CKD (trend)
Genotype-specific trends
- Greater glycemic improvement in HNF1A/HNF4A-MODY and greater UACR reduction in MIDD (trends)
eGFR
- eGFR declined modestly over time
Safety
Safety · 23.9 ± 5.9 months follow-up
- Non-serious adverse events
- 15% of patients
- Discontinued treatment
- 7.5%
- No ketoacidosis, acute kidney injury or deaths reported
Original publication
Glycemic and Renal Effects of SGLT2 Inhibitors in Monogenic Diabetes: A Real‐World National Study. Diabetes Obes Metab. Published 6 August 2026. doi:10.
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