Work

Kidney outcomes with SGLT2 inhibitors in patients with diabetes and an insulin‐deficient phenotype: A real world analysis

Year: 2025

Type: article

Abstract: Aim Diabetic kidney disease (DKD) is a major complication of diabetes, including in insulin‐deficient phenotypes, yet data on kidney outcomes with sodium‐glucose cotransporter 2 inhibitors (SGLT2i) in this population are limited. This study investigates the impact of SGLT2i on kidney outcomes in patients with insulin‐deficient diabetes using real world data. Materials and Methods This retrospective cohort study utilized data from a large Health Maintenance Organization in Israel and included 12,530 propensity score‐matched adults with insulin‐deficient diabetes. Patients were categorized into SGLT2i users and non‐users and followed for a median of 1657 days. The primary outcome was a composite of ≥50% decline in eGFR to <60 mL/min/1.73 m 2 or progression to eGFR <15 mL/min/1.73 m 2 . Secondary outcomes included doubling of serum creatinine and changes in albuminuria category. Results SGLT2i use was associated with a reduced incidence of the primary outcome (6.1% vs. 7.5%; HR 0.79, p < 0.001). Secondary analyses revealed significant reductions in serum creatinine doubling (HR 0.76, p < 0.001) and improvements in albuminuria, with 51% of SGLT2i users transitioning to normoalbuminuria. Benefits were consistent across subgroups. Although diabetic ketoacidosis (DKA) incidence was higher among SGLT2i users (2.81% vs. 2.19%, p = 0.03), the overall frequency was low. Conclusions 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.

Source: Diabetes Obesity and Metabolism

DOI: 10.1111/dom.16329

Authors: Anat Tsur, Avivit Cahn, Lior Hanoch, Rena Pollack

Institutions: Hebrew University of Jerusalem, Clalit Health Services, Hadassah Medical Center

Language: English

Topic: Chronic Kidney Disease and Diabetes

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $5,380