Study highlights safety concerns of SGLT2i in patients with diabetes and cancer

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Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have heart- and kidney-related benefits in patients with and without diabetes that extend beyond their primary indication for lowering blood sugar levels. In clinical trials, the risk of serious adverse events with SGLT2i was low, but the safety outcome of SGLT2i in patients with cancer is unknown. A new study highlights the risk of adverse events associated with SGLT2i in diabetic patients who also have cancer. The study results will be presented at ASN Kidney Week 2023, November 1-November 5.

For the study, investigators evaluated outcomes in 3,872 patients with diabetes and cancer who were given SGLT2i and 3,189 patients who were given another diabetes drug called glucagon-like peptide 1 receptor agonist (GLP-1 RA).

Compared to GLP-1 RA, SGLT2i was associated with a higher risk of diabetic ketoacidosis (a build-up of acid in the blood) and fractures but a lower risk of acute kidney injury and urinary tract infection. There was no difference in the incidence of hypovolemia (fluid depletion), low blood pressure, and genital tract infections between the SGLT2i and GLP-1 RA groups.

This is the first study to evaluate the safety outcomes of SGLT2i in patients with diabetes and cancer. “Study findings may inform patient-physician decision-making regarding the risks of SGLT2i in these patients.”

Ayesha Sheikh, MD, corresponding author, Memorial Sloan Kettering Cancer Center

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