Key result
SGLT2 inhibitors linked to ~14% lower ischaemic stroke risk in patients with T2D and CKD.
Why the study?
The effect of SGLT2 inhibitors on reducing ischaemic and haemorrhagic strokes in patients with type 2 diabetes and chronic kidney disease remains unclear.
Does SGLT2i therapy reduce the risk of incident ischaemic and haemorrhagic strokes in patients with Type 2 Diabetes and Chronic Kidney Disease?
Cohort (n=215,638)
Does SGLT2i therapy reduce the risk of incident ischaemic and haemorrhagic strokes in patients with Type 2 Diabetes and Chronic Kidney Disease?
In a real-world Taiwanese cohort of patients with type 2 diabetes and chronic kidney disease, SGLT2 inhibitor use was associated with a significant reduction in the risk of both new-onset ischaemic and haemorrhagic strokes compared to non-use.
Answers are grounded in this paper and cite their sources.
SGLT2i use was associated with lower stroke risk in T2D-CKD; extends low-certainty observational data but leaves open need for RCTs before practice change.
BACKGROUND: Type 2 diabetes (T2D) and chronic kidney disease (CKD) increase the risk of ischaemic and haemorrhagic strokes. However, the effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on reducing the risk of ischaemic and haemorrhagic strokes in patients with T2D and CKD remains unclear. Thus, this study was conducted to explore the role of SGLT2i in the prevention of ischaemic and haemorrhagic strokes. METHODS: In this retrospective cohort study, Cox regression analysis was employed to examine the hazard ratio (HR) between users and nonusers of SGLT2i on incident ischaemic and haemorrhagic strokes following 1:1 propensity score matching. The Kaplan-Meier method was used to determine the risk of study outcome over time between users and nonusers of SGLT2i. Finally, a sensitivity analysis of the HR was performed between users and nonusers of SGLT2i on incident ischaemic and haemorrhagic strokes after 1:2 sex and age matching. RESULTS: After 1:1 propensity score matching of patients by age, sex, T2D duration, and comorbidities, 107,819 users of SGLT2i and 107,819 nonusers were enrolled for analysis. SGLT2i therapy was associated with significantly reduced incidence of ischaemic and haemorrhagic strokes (HR 0.86, [95% CI, 0.81-0.90]; HR 0.80, [95% CI, 0.74-0.87]). Furthermore, the HR was even more significant in the sensitivity test for incident ischaemic and haemorrhagic strokes. CONCLUSION: SGLT2i reduced the risk of incident ischaemic and haemorrhagic strokes among patients with T2D and CKD. The protective profile of the SGLT2i against incident ischaemic and haemorrhagic strokes makes it a clinical option for those with T2D with CKD.
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Lin et al. (2026) conducted a cohort in Type 2 diabetes with chronic kidney disease (n=215,638). Sodium-glucose cotransporter 2 inhibitors (SGLT2i) vs. SGLT2i nonusers was evaluated on Incident ischaemic stroke (rate per 10,000 person-months) (HR 0.86, 95% CI 0.81-0.90, p=<0.0001). SGLT2 inhibitors significantly reduced the risk of incident ischaemic (HR 0.86) and haemorrhagic (HR 0.80) strokes compared to nonuse in patients with type 2 diabetes and chronic kidney disease.
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