SGLT2 inhibitor therapy significantly improved global longitudinal strain at 6 months in patients with type 2 diabetes across both normal weight and overweight/obese categories (both p<0.001).
Cohort (n=614)
Does SGLT2 inhibitor therapy improve global longitudinal strain in patients with type 2 diabetes across different BMI categories?
SGLT2 inhibitors are associated with significant improvements in subclinical left ventricular systolic function (GLS) at 6 months in patients with type 2 diabetes, regardless of baseline BMI.
p-value: p=<0.001
BACKGROUND Type 2 diabetes mellitus is associated with subclinical left ventricular dysfunction. SGLT2 inhibitors demonstrate cardiovascular benefits in trials, but their effects on subclinical myocardial function and relationship to body weight in clinical practice remain unclear. This study examined global longitudinal strain (GLS) changes during SGLT2 inhibitor therapy across body mass index (BMI) categories. METHODS This prospective observational cohort enrolled 614 patients newly initiated on SGLT2 inhibitors (September 2022-May 2025), stratified by BMI: normal weight (n = 300) and overweight/obesity (n = 314). Speckle tracking echocardiography assessed GLS at baseline and 6 months. RESULTS Both groups showed significant GLS improvement (normal weight: -17.83 ± 1.30% to -19.22 ± 1.20%; overweight/obesity: -17.70 ± 1.48% to -19.05 ± 1.24%; both p < 0.001), with similar magnitude (p = 0.696). Overweight/obesity patients experienced modest BMI reduction (-0.66 kg/m2, p < 0.001); normal weight remained stable. Baseline GLS strongly predicted improvement (OR = 1.553, p < 0.001), while baseline BMI showed no association (OR = 1.000, p = 0.993). CONCLUSION SGLT2 inhibitor therapy was associated with similar subclinical left ventricular systolic function improvement across BMI categories. While causality cannot be established without controls and BMI imperfectly measures adiposity, findings align with randomized trial cardiovascular benefits, suggesting benefits may extend across the body weight spectrum.
Kümet et al. (2026) conducted a cohort in Type 2 diabetes mellitus (n=614). SGLT2 inhibitors vs. Baseline (pre-treatment) and across BMI categories was evaluated on Global longitudinal strain (GLS) changes at 6 months (p=<0.001). SGLT2 inhibitor therapy significantly improved global longitudinal strain at 6 months in patients with type 2 diabetes across both normal weight and overweight/obese categories (both p<0.001).