Sodium–Glucose Cotransporter 2 Inhibition in Diabetic Macular Oedema: Emerging Evidence for Stage‐Dependent Systemic‐Retinal Responsiveness
Authors' conclusion
This predominantly observational evidence suggests that SGLT2 inhibitors may be associated with slower DMO disease kinetics across retinopathy stages, with reduced treatment burden most evident before severe retinopathy.
Study context
- Population
- Studies of SGLT2i and DME published January 2014 to April 2026 (PubMed, Cochrane Library, ClinicalTrials.gov, WHO-ICTRP, Google Scholar)40 studies
- Comparison
- SGLT2i use in DME
- Outcome
- DMO incidence and DR progression with SGLT2i use (large administrative databases)
Methodological detailsPRISMA-ScR, prospectively registered, qualitative meta-summary, exploratory E-value analyses, Two reviewers independently screened and charted records, Heterogeneity precluded meta-analysis
- PRISMA-ScR
- Prospectively registered
- Qualitative meta-summary
- Exploratory E-value analyses
- Two reviewers independently screened and charted records
- Heterogeneity precluded meta-analysis
Main finding
As reported in the abstract
Lower diabetic macular oedema (DMO) incidence with SGLT2i use
16%-35%
HR for DMO incidence
0.65-0.84
HR for DR progression
0.53-0.94
Further findings
Proposed mechanisms
- Suppression of microglial activation, oxidative stress and angiopoietin-2/VEGF signalling; translational evidence remains preclinical
Original publication
Sodium–Glucose Cotransporter 2 Inhibition in Diabetic Macular Oedema: Emerging Evidence for Stage‐Dependent Systemic‐Retinal Responsiveness. Diabetes Obes Metab. Published 2 September 2026. doi:10.
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