What question did this study set out to answer?

The study aims to evaluate the effects of SGLT2 inhibitors on cardiorenal toxicity and survival in patients with type 2 diabetes undergoing antineoplastic therapy.

March 21, 2026

SGLT2 inhibitors mitigate cardiorenal toxicity and improve survival in type 2 diabetes mellitus patients undergoing antineoplastic therapy: A multicenter retrospective cohort study

Key Result

SGLT2 inhibitors reduced cardiovascular events by 86.1% and all-cause mortality by 84.7% in type 2 diabetes patients undergoing antineoplastic therapy.

Key Points

The study aims to evaluate the effects of SGLT2 inhibitors on cardiorenal toxicity and survival in patients with type 2 diabetes undergoing antineoplastic therapy.
Multicenter retrospective cohort study design
248 type 2 diabetes mellitus–cancer patients analyzed
Participants divided into SGLT2i and non-SGLT2i groups
Follow-up period of 30.4 months
Echocardiography and renal function tests conducted
SGLT2 inhibitors reduced cardiovascular events by 86.1% (OR = 0.139)
All-cause mortality reduced by 84.7% (HR = 0.153)
Improved left ventricular ejection fraction and reduced left ventricular end-diastolic diameter
Preserved renal function despite lower baseline eGFR in SGLT2i group
Reduced uric acid levels by 23.6%

Structured PICO

Does SGLT2i reduce cardiovascular events and all-cause mortality in T2DM-cancer patients undergoing antineoplastic therapy?

Population

Type 2 diabetes mellitus (T2DM) patients with cancer undergoing antineoplastic therapy (mean age 66.7 years, 56.0% male)

Intervention

Sodium-glucose cotransporter 2 inhibitors (SGLT2i)

Comparator

Non-SGLT2i therapy

Outcome

Cardiovascular events and all-cause mortalityhard clinical

SGLT2 inhibitors significantly reduce cardiovascular events and all-cause mortality while preserving cardiorenal function in patients with T2DM and cancer undergoing antineoplastic therapy.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Asia faces a rising cancer burden, with type 2 diabetes mellitus (T2DM) prevalence in cancer patients at 24.4% (2.3‐fold higher than that of the general population). Antineoplastic therapies (e.g., anthracyclines and vascular endothelial growth factor receptor VEGFR inhibitors) increase cardiorenal toxicity, exacerbated by T2DM. Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) benefit non‐oncologic populations but are understudied in T2DM–cancer patients. We assessed SGLT2i's effects on antineoplastic‐related cardiorenal toxicity/survival via a multicenter retrospective cohort of 248 T2DM–cancer patients (56.0% male, mean age 66.7 years) 1:1 divided into SGLT2i/non‐SGLT2i groups. Over 30.4 months of follow‐up, SGLT2i reduced cardiovascular events by 86.1% (odds ratio OR = 0.139, 95% CI 0.027–0.710, p = .018) and all‐cause mortality by 84.7% (HR = 0.153, 95% CI 0.055–0.431, p < .001). Echocardiography showed improved left ventricular ejection fraction (LVEF) and reduced left ventricular end‐diastolic diameter (LVID)/left atrial (LA) dimensions (all p < .001). Despite lower baseline estimated glomerular filtration rate (eGFR) in the SGLT2i group, SGLT2i preserved renal function (post‐treatment eGFR: 99.8 vs. 67.5 mL/min/1.73 m 2 ; p = .054) and reduced uric acid (UA) levels by 23.6% ( p < .001). Benefits persisted across solid tumor/hematological malignancies and anthracycline‐based therapy, targeted antineoplastic therapy or immunotherapy subgroups, with no increase in infection. SGLT2i improve cardiorenal outcomes and survival in T2DM–cancer patients warranting prospective validation.

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