SGLT2 inhibitor therapy and lower incidence of iron deficiency anaemia in patients with type 2 diabetes: A retrospective cohort study from Germany
Main finding · Cumulative incidence of IDAResult — go to the resultHazard ratio 0.67 95% CI 0.58–0.78Authors' conclusion
SGLT2i therapy was associated with a lower incidence of IDA in T2DM patients compared to DPP-4i therapy. These findings suggest a potential hematologic benefit of SGLT2 inhibitors, warranting further investigation in randomised controlled trials.
Study context
- Population
- Patients with T2D (≥18 years) initiating SGLT2i or DPP-4i alongside metformin 2012–2022, without prior anaemia; IQVIA Disease Analyzer, Germanymatched cohort
- Participants
- 28,441 vs 28,441
- Exposure
- SGLT2i vs DPP-4i, alongside metformin
- SGLT2in = 28,441
- DPP-4in = 28,441reference
- Outcome
- Incidence of iron deficiency anaemia (IDA)
- Follow-up
- 5-year follow-up
Methodological detailspropensity-score matched (1:1), electronic medical records database, office-based practices
- Propensity-score matched (1:1)
- Electronic medical records database
- Office-based practices
Main finding
Cumulative incidence of IDA · 5 years
Hazard ratio
0.67
95% CI 0.58–0.78
P < 0.001
By group
SGLT2ivs DPP-4i
HR 0.67 (95% CI 0.58–0.78); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Iron deficiency anaemia (IDA) risk by subgroup (sex, age, metformin duration)
- Association confirmed in males and elder patients (>60 years)
- Protective effect limited to metformin use under 3 years
Original publication
SGLT2 inhibitor therapy and lower incidence of iron deficiency anaemia in patients with type 2 diabetes: A retrospective cohort study from Germany. Diabetes Obes Metab. Published 22 August 2025. doi:10.
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