The following is a summary of “Sodium-Glucose Cotransporter 2 Inhibitors and New-onset Type 2 Diabetes in Adults With Prediabetes: Systematic Review and Meta-analysis of Randomized Controlled Trials,” published in the January 2023 issue of Endocrinology & Metabolism by Mori, et al.

In secondary analyses of several randomized controlled trials (RCTs), the preventative impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors for new-onset diabetes was examined. The outcomes were contradictory, though. Therefore, for a study, researchers sought to investigate whether SGLT2 inhibitors were beneficial in preventing new-onset diabetes by synthesizing the available data.

Until February 11, 2022, MEDLINE, EMBASE, and the Cochrane Central Registry of Controlled Trials were searched for the systematic review and meta-analysis of RCTs. To compare the risk of new-onset diabetes among people with prediabetes, two independent authors examined the search results and retrieved summary information from appropriate RCTs (including original and post hoc analyses). In addition, a meta-analysis was performed to determine risk ratios and 95% confidence intervals.

With 5,655 prediabetic patients, they included 4 RCTs. The random-effects meta-analysis revealed that SGLT2 inhibitors significantly reduced the risk of newly developing diabetes (relative risk, 0.79; 95% CI, 0.68-0.93). The relative risks of new-onset diabetes were 0.68 (95% CI, 0.52-0.89) and 0.87 (95% CI, 0.72-1.04), respectively, for dapagliflozin and empagliflozin (P for heterogeneity =.14). Comparing the SGLT2 inhibitors group to the placebo group, there was no difference in the frequency of severe hypoglycemia.

In the meta-analysis, persons with prediabetes who also had heart failure or chronic kidney disease used SGLT2 inhibitors and saw a lower chance of developing type 2 diabetes for the first time. The results pointed to the potential value of SGLT2 inhibitors in managing prediabetes in high-risk populations.

Reference: academic.oup.com/jcem/article-abstract/108/1/221/6755521?redirectedFrom=fulltext