Initiation of sodium-glucose cotransporter-2 inhibitors at lower HbA1c threshold attenuates estimated-glomerular filtration rate (eGFR) decline in type 2 diabetes patients with and without cardiorenal disease: A propensity-matched cohort study
Authors' conclusion
In this real-world study, SGLT2i initiation at HbA1c < 7.5 % was associated with slower eGFR decline especially in high risk patients, supporting the potential renal benefits of SGLT2i initiation at lower glycemic thresholds.
Study context
- Population
- Chinese patients with T2D from Hong Kong initiating SGLT2i; mean age 60.2 ± 11.5 years, 62.1% male
- Participants
- 3,384 patients
- Exposure
- SGLT2i initiation at HbA1c <7.5% vs ≥7.5%
- Outcome
- Annual eGFR change
- Follow-up
- Median 1.9 years
Methodological details1:1 propensity score matched
- 1:1 propensity score matched
Main finding
As reported in the abstract
Post-index annual eGFR decline
Lower-HbA1c
−0.99
mL/min/1.73 m²
Higher-HbA1c
−1.63
mL/min/1.73 m²
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Rapid eGFR decline (>4% per year) | 0.15 (0.07–0.29) | |
| 0.050.21520Odds ratio (log scale) |
Baseline HbA1c
Subgroups
- Greater renoprotection with Lower-HbA1c in those with baseline eGFR <60 mL/min/1.73 m², albuminuria and/or treatment with renin-angiotensin-system inhibitors or insulin
Original publication
Initiation of sodium-glucose cotransporter-2 inhibitors at lower HbA1c threshold attenuates eGFR decline in type 2 diabetes patients with and without cardiorenal disease: A propensity-matched cohort study. Diabetes Res Clin Pract. Published 6 December 2022. doi:10.
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