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Effect of sodium–glucose cotransporter 2 inhibitors on hemoglobin and hematocrit levels in type 2 diabetes: a systematic review and meta-analysis

  • Nephrology - Review
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Abstract

Background

Sodium–glucose cotransporter 2 inhibitors (SGLT2i) improve outcomes of patients with type 2 diabetes at high cardiovascular risk and chronic kidney disease. Recent studies showed an increase in hemoglobin and hematocrit after SGLT2i treatment.

Materials and methods

We did a systematic review and meta-analysis of randomized, double-blind, placebo-controlled studies of SGLT2i in patients with type 2 diabetes. We searched through PubMed/Medline, Web of Science, Embase (Elsevier), and the Cochrane Central Register of Controlled Trials (Wiley) from January 2010 to January 2021.

Results

We included seventeen randomized, double-blind, placebo-controlled studies. The total number of evaluated patients was 14,748. The treatment arm consisted of canagliflozin, dapagliflozin, empagliflozin and ipragliflozin. SGLT2i therapy significantly increased hemoglobin levels when compared to placebo (MD 5.60 g/L, 95% CI 3.73–7.47 g/L, P < 0.00001, considerable heterogeneity—I2 = 94%). Each SGLT2i also led to a significant increase in the hematocrit level when compared to placebo (MD 1.32%, 95% CI 1.21–1.44, P < 0.00001, considerable heterogeneity—I2 = 99%).

Conclusions

SGLT2i led to significant increases in hemoglobin and hematocrit levels when compared to placebo. In addition to their cardiovascular effect, SGLT2i also increases hemoglobin and hematocrit levels.

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Acknowledgements

MK gratefully acknowledges the use of the services and facilities of the Koc University Research Center for Translational Medicine (KUTTAM), funded by the Presidency of Turkey, Presidency of Strategy and Budget. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Presidency of Strategy and Budget.

Funding

AC, LT and CU gratefully acknowledge the grant of the Ministry of Research, Innovation and Digitization, CNCS/CCCDI-UEFISCDI, project number PN-III-P4-ID-PCE-2020-2393, within PNCDIII.

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey

    Mehmet Kanbay

  2. Cardiovascular Diseases Institute, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania

    Laura Tapoi & Carina Ureche

  3. Department of Medicine, Koc University School of Medicine, Istanbul, Turkey

    Cem Tanriover, Enes Cevik & Atalay Demiray

  4. Division of Nephrology, Department of Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey

    Baris Afsar

  5. Division of Nephrology, Department of Medicine, Toronto General Hospital, University of Toronto, Toronto, ON, Canada

    David Z. I. Cherney

  6. Department of Nephrology, “Grigore T. Popa” University of Medicine, Iasi, Romania

    Adrian Covic

  7. Nephrology Clinic, Dialysis and Renal Transplant Center, ‘C.I. Parhon’ University Hospital, Iasi, Romania

    Adrian Covic

  8. The Academy of Romanian Scientists (AOSR), Bucharest, Romania

    Adrian Covic

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  1. Mehmet Kanbay
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Contributions

Contributed substantially to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: AC, EC, CT, AD, CU, LT and MK. Drafted the work or revised it critically for important intellectual content: BA, AC, DC, AO and MK. Approved the final version to be published: AC, EC, CT, AD, CU, LT, DC and MK.

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Correspondence to Mehmet Kanbay.

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Kanbay, M., Tapoi, L., Ureche, C. et al. Effect of sodium–glucose cotransporter 2 inhibitors on hemoglobin and hematocrit levels in type 2 diabetes: a systematic review and meta-analysis. Int Urol Nephrol 54, 827–841 (2022). https://doi.org/10.1007/s11255-021-02943-2

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