Kidney outcomes with SGLT2 inhibitors in patients with diabetes and an insulin‐deficient phenotype: A real world analysis
Authors' conclusion
SGLT2i demonstrated substantial kidney protection in insulin-deficient patients, extending benefits beyond type 2 diabetes. These findings highlight SGLT2i as a potential therapeutic option for mitigating DKD in high-risk populations.
Study context
- Population
- Adults with insulin-deficient diabetes, large Health Maintenance Organization in Israelpropensity score-matched
- Participants
- 12,530 adults
- Exposure
- SGLT2i users vs non-users
- Outcome
- Composite of:
- ≥50% decline in eGFR to <60 mL/min/1.73 m²
- Progression to eGFR <15 mL/min/1.73 m²
- Follow-up
- Median 1657 days
Methodological detailspropensity score-matched, real world data
- Propensity score-matched
- Real world data
Main finding
As reported in the abstract
Composite of:
- ≥50% eGFR decline to <60 mL/min/1.73 m²
- Progression to eGFR <15 mL/min/1.73 m²
SGLT2i use associated with reduced incidence of the primary outcome
HR 0.79
p < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR | P value |
|---|---|---|
| Doubling of serum creatinine | 0.76 | P < 0.001 |
Albuminuria category
- SGLT2i users transitioning to normoalbuminuria
- 51%
Subgroups
- Benefits were consistent across subgroups
Safety
DKA incidence
P = 0.03
Diabetic ketoacidosis (DKA) incidence
- Overall DKA frequency was low
Original publication
Kidney outcomes with SGLT2 inhibitors in patients with diabetes and an insulin‐deficient phenotype: A real world analysis. Diabetes Obes Metab. Published 14 March 2025. doi:10.
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