SGLT2 Inhibitors

DECLARE-TIMI 58: Dapagliflozin Reduces Heart Failure Hospitalisation Across a Broader Type 2 Diabetes Population

The DECLARE-TIMI 58 trial demonstrated that dapagliflozin did not reduce 3-point MACE compared with placebo but significantly reduced the composite of cardiovascular death or hospitalisation for heart failure, driven entirely by a 27% reduction in heart failure hospitalisation, in the largest and most broadly representative SGLT2 inhibitor cardiovascular outcomes trial conducted to date.

CANVAS Programme: Canagliflozin Reduces Cardiovascular Events but Increases Amputation Risk in Type 2 Diabetes

The CANVAS Programme demonstrated that canagliflozin reduced major adverse cardiovascular events by 14% in patients with type 2 diabetes at high cardiovascular risk, but identified an approximately twofold increase in lower-extremity amputation risk, primarily at the toe or metatarsal level, requiring careful patient selection and monitoring.

EMPA-REG OUTCOME: Empagliflozin Cuts Cardiovascular Death by 38% in High-Risk Type 2 Diabetes

The EMPA-REG OUTCOME trial demonstrated that empagliflozin reduced cardiovascular death by 38% and heart failure hospitalisation by 35% in patients with type 2 diabetes and established cardiovascular disease — the first glucose-lowering agent to show a mortality benefit in a cardiovascular outcomes trial.

How does empagliflozin affect inflammation timing in macrophages from post-heart attack diabetics?

An ex-vivo study finds early empagliflozin dampens NLRP3 inflammasome activity in macrophages from post-MI diabetic patients, a mechanistic signal. PICO summary and commentary.

Can Combining SGLT2 and DPP-4 Inhibitors Normalize Urinary Microbiota in Type 2 Diabetes?

A small exploratory study finds combining empagliflozin with linagliptin shifts urinary microbiota toward a healthy pattern in type 2 diabetes, while empagliflozin alone raises some uropathogens; infection rates were not measured. PICO summary and commentary.

Can Nutrition Boost Dapagliflozin’s Benefits in Diabetic Patients?

A 6-month open-label RCT finds adding a Mediterranean diet and nutritional supplements to dapagliflozin improves glycaemia, albuminuria, nutrition, and quality of life more than dapagliflozin alone in diabetic nephropathy. PICO summary and commentary.

Can Dapagliflozin and Liraglutide Protect Against Cognitive Decline in Type 2 Diabetes?

Can SGLT2 Inhibitors Reduce Eye Injection Needs in Diabetic Patients with High Blood Pressure?

A small post hoc COMET subgroup finds SGLT2 inhibitor use is associated with about half as many eye injections in diabetic macular edema with high blood pressure, an exploratory finding from 29 patients. PICO summary and commentary.

How Does Blood Pressure Affect Treatment Response to SGLT2 Inhibitors in Diabetic Macular Edema?

How Does Empagliflozin Affect Heart Failure in Type 2 Diabetes Patients?

A small biomarker RCT finds empagliflozin reduces the renal tubular marker KIM-1 in diabetic heart failure with preserved ejection fraction, with no effect on other biomarkers. PICO summary and commentary.