Real-World Renal and Metabolic Outcomes of SGLT-2 Inhibitor Therapy in Patients with Type 2 Diabetes Mellitus
- 1Department of Internal Medicine, Dokuz Eylul University Research and Training Hospital, 35330 Izmir, Turkey
- 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University Research and Training Hospital, 35330 Izmir, Turkey
Abstract
Background/Objectives: Real-world data are limited for short-term renal and metabolic changes after the initiation of sodium–glucose co-transporter 2 (SGLT2) inhibitors in Turkish clinical practice. We described 1-year changes in these parameters in adults with type 2 diabetes who started treatment with empagliflozin or dapagliflozin. Methods: In this single-centre retrospective cohort (2016–2021; n = 780), paired baseline and 12-month values were compared in patients with available measurements. The urinary albumin-to-creatinine ratio (UACR) was compared with the Wilcoxon signed-rank test. Factors associated with albuminuria response (≥30% UACR reduction) were examined using multivariable logistic regression. Results: HbA1c decreased by 1.0% (95% CI 0.8–1.1; n = 398), haematocrit increased by 1.3 percentage points (n = 418), uric acid decreased by 0.5 mg/dL (n = 221) and eGFR declined by 3.2 mL/min/1.73 m2 (95% CI 2.1–4.2; n = 426). In 109 patients with paired UACR, the median UACR fell from 20.9 [9.0–49.0] to 11.0 [6.0–30.0] mg/g (p < 0.001). A ≥30% reduction occurred in 81.1% of patients with a baseline UACR ≥30 mg/g and 41.7% of patients with a baseline UACR <30 mg/g (adjusted odds ratio: 6.10; 95% CI: 2.24–16.57). Genitourinary infections were more frequent in women as the most common documented reason for discontinuation. Conclusions: In routine care, SGLT2 inhibitor initiation was followed by changes in glycaemic, haematological, uric acid and albuminuria parameters that were similar in direction to those reported in randomised trials; the uncontrolled design and incomplete UACR data preclude causal inference.
Related
- Development and validation of a novel metabolic-inflammatory health-related nomogram for predicting in-hospital mortality in older patients with type 2 diabetes mellitus combined with cardiovascular disease
- Effects of Metformin on Clinical Outcomes After Acute Ischemic Stroke in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
- Effects of intensive insulin therapy combined with non-insulin antihyperglycemic agents on glycemic control, variability, and metabolic outcomes in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.
- The Relationship Between Intuitive Eating, Diabetes-Related Health Knowledge, and Psychological Health Outcomes in Patients with Type 2 Diabetes Mellitus.
- Factors associated with significant liver fibrosis in patients with type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease: a single-center retrospective study
BibTeX
@article{unsal2026realworld,
title = {{Real-World Renal and Metabolic Outcomes of SGLT-2 Inhibitor Therapy in Patients with Type 2 Diabetes Mellitus}},
author = {Öykü Ünsal and Hüseyin Döngelli and Mehmet Çağrı Ünal and Gökçen Güngör Semiz and Aysu Okumuş Güçlü and Tevfik Demir},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208076},
url = {https://www.mdpi.com/2077-0383/15/20/8076},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Real-World Renal and Metabolic Outcomes of SGLT-2 Inhibitor Therapy in Patients with Type 2 Diabetes Mellitus
AU - Öykü Ünsal
AU - Hüseyin Döngelli
AU - Mehmet Çağrı Ünal
AU - Gökçen Güngör Semiz
AU - Aysu Okumuş Güçlü
AU - Tevfik Demir
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208076
UR - https://www.mdpi.com/2077-0383/15/20/8076
AB - Background/Objectives: Real-world data are limited for short-term renal and metabolic changes after the initiation of sodium–glucose co-transporter 2 (SGLT2) inhibitors in Turkish clinical practice. We described 1-year changes in these parameters in adults with type 2 diabetes who started treatment with empagliflozin or dapagliflozin. Methods: In this single-centre retrospective cohort (2016–2021; n = 780), paired baseline and 12-month values were compared in patients with available measurements. The urinary albumin-to-creatinine ratio (UACR) was compared with the Wilcoxon signed-rank test. Factors associated with albuminuria response (≥30% UACR reduction) were examined using multivariable logistic regression. Results: HbA1c decreased by 1.0% (95% CI 0.8–1.1; n = 398), haematocrit increased by 1.3 percentage points (n = 418), uric acid decreased by 0.5 mg/dL (n = 221) and eGFR declined by 3.2 mL/min/1.73 m2 (95% CI 2.1–4.2; n = 426). In 109 patients with paired UACR, the median UACR fell from 20.9 [9.0–49.0] to 11.0 [6.0–30.0] mg/g (p < 0.001). A ≥30% reduction occurred in 81.1% of patients with a baseline UACR ≥30 mg/g and 41.7% of patients with a baseline UACR <30 mg/g (adjusted odds ratio: 6.10; 95% CI: 2.24–16.57). Genitourinary infections were more frequent in women as the most common documented reason for discontinuation. Conclusions: In routine care, SGLT2 inhibitor initiation was followed by changes in glycaemic, haematological, uric acid and albuminuria parameters that were similar in direction to those reported in randomised trials; the uncontrolled design and incomplete UACR data preclude causal inference.
SN - 2077-0383
ER -