SGLT2 inhibitors improve subclinical left ventricular systolic function independent of body mass index in patients with type 2 diabetes: A prospective strain imaging study
Authors' conclusion
SGLT2 inhibitor therapy was associated with similar subclinical left ventricular systolic function improvement across BMI categories. While causality cannot be established without controls and BMI imperfectly measures adiposity, findings align with randomized trial cardiovascular benefits, suggesting benefits may extend across the body weight spectrum.
Study context
- Population
- Patients with T2D newly initiated on SGLT2i (September 2022-May 2025)
- Participants
- 614 patients
- Exposure
- Normal weight vs overweight/obesity during SGLT2i therapy
- Normal weightn = 300reference
- Overweight/obesityn = 314
- Outcome
- GLS change by speckle tracking echocardiography
- Follow-up
- Baseline and 6 months
Methodological detailsspeckle tracking echocardiography, stratified by body mass index (BMI)
- Speckle tracking echocardiography
- Stratified by BMI
Main finding
As reported in the abstract
GLS, baseline to 6 months
Normal weight
−17.83 ± 1.30% to −19.22 ± 1.20%
Overweight/obesity
−17.70 ± 1.48% to −19.05 ± 1.24%
P = 0.696
- Significant global longitudinal strain (GLS) improvement in both groups
- both p < 0.001
Observational data: associations, not effects.
Further findings
- BMI change · 6 months — Overweight/obesity
- −0.66 kg/m²
- BMI change — BMI reduction in overweight/obesity
- p < 0.001
BMI change · 6 months
- Normal weight BMI remained stable
Predictors of GLS improvement
- Baseline GLS, OR
- 1.553, p < 0.001
- Baseline BMI, OR
- 1.000, p = 0.993
Original publication
SGLT2 inhibitors improve subclinical left ventricular systolic function independent of body mass index in patients with type 2 diabetes: A prospective strain imaging study. Diabetes Res Clin Pract. Published 7 February 2026. doi:10.
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