Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients
Questioning Medicine4 Helmi 2025

Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients

Gao FM et al. A systematic review and meta-analysis on the safety and efficacy of sodium–glucose cotransporter 2 inhibitor use in hospitalized patients. Diabetes Care 2024 Dec 1; 47:2275. (https://doi.org/10.2337/dc24-0946)

Trial Results

SGLT-2 inhibitors, crucial in managing diabetes, kidney disease, and heart failure, have shown promising results in hospitalized patients

1

. The meta-analysis, covering 23 randomized controlled trials with 20,000 participants, revealed:

  1. No significant increase in ketoacidosis rates (0.21 vs. 0.14 per 100 person-years)

1

  1. Lower mortality and fewer readmissions in heart failure patients

1

  1. Reduced incidence of acute kidney injury overall

1

These findings suggest that SGLT-2 inhibitors can be safely continued or initiated in hospitalized patients, particularly those with heart failure

1

.

Limitations

However, it's important to note some limitations:

  1. Potential underpowering: The study might not have had enough statistical power to detect small differences in ketoacidosis rates

1

.

  1. Risk underestimation: Including outpatient follow-up periods may have diluted the true risk of ketoacidosis during hospitalization

1

.

  1. Patient diversity: Only 30% of participants had diabetes, which might not fully represent the typical hospital population

1

.

Conclusion

While the results are encouraging, caution is still advised. The study supports current recommendations for SGLT-2 inhibitor use in hospitalized patients, especially those with heart failure, but emphasizes the need for careful monitoring and individualized decision-making

1

.This concludes our brief podcast on SGLT-2 inhibitors in hospitalized patients. Thank you for listening, and stay tuned for more updates on diabetes care and management.

Jaksot(386)

Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

Episode 360: 259. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients

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Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

Episode 359: 258. Oral Antibiotics and Risk of Serious Cutaneous Adverse Drug Reactions

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Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

Episode 358: 257. Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention

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Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

Episode 357: 256. Medications for alcohol-use disorder and follow-up after hospitalization

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Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

Episode 356: 255. Real-world use of glucocorticoids for adults hospitalized with community-acquired pneumonia

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Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

2024 ESC guidelines propose a simple new BP categorization: Non-elevated: less than 120/70 mm Hg in the office (pharmacological treatment is not recommended). Elevated: 120 to 139/70 to 89 mm Hg (phar...

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Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Episode 354: 253. Centralized Colorectal Cancer Screening Outreach in Federally Qualified Health Centers

Question  Does adding centralized mailed fecal immunochemical testing and patient navigation to usual care improve colorectal cancer (CRC) screening in US federally qualified health centers? pragmatic...

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Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Episode 353: 252. 2.4 Million to Prevent 4 Hospitalizations!

Packer M et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2024 Nov 16; [e-pub].https://doi.org/10.1056/NEJMoa2410027  In the industry-funded SUMMIT trial...

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