Real-World Renal and Metabolic Outcomes of SGLT-2 Inhibitor Therapy in Patients with Type 2 Diabetes Mellitus

Background/Objectives: Real-world data are limited for short-term renal and metabolic changes after the initiation of sodium–glucose co-transporter 2 (SGLT2) inhibitors in Turkish clinical practice. We described 1-year changes in these parameters in adults with type 2 diabetes who started treatment with empagliflozin or dapagliflozin.

Methods

In this single-centre retrospective cohort (2016–2021; n = 780), paired baseline and 12-month values were compared in patients with available measurements. The urinary albumin-to-creatinine ratio (UACR) was compared with the Wilcoxon signed-rank test. Factors associated with albuminuria response (≥30% UACR reduction) were examined using multivariable logistic regression.

Results

HbA1c decreased by 1.0% (95% CI 0.8–1.1; n = 398), haematocrit increased by 1.3 percentage points (n = 418), uric acid decreased by 0.5 mg/dL (n = 221) and eGFR declined by 3.2 mL/min/1.73 m2 (95% CI 2.1–4.2; n = 426). In 109 patients with paired UACR, the median UACR fell from 20.9 [9.0–49.0] to 11.0 [6.0–30.0] mg/g (p < 0.001). A ≥30% reduction occurred in 81.1% of patients with a baseline UACR ≥30 mg/g and 41.7% of patients with a baseline UACR <30 mg/g (adjusted odds ratio: 6.10; 95% CI: 2.24–16.57). Genitourinary infections were more frequent in women as the most common documented reason for discontinuation.