Effects of sodium‐glucose co‐transporter‐2 inhibitors in type 2 diabetes in women versus men

TLDR

Sodium‑glucose co‑transporter‑2 (SGLT2) inhibitors prevent cardiovascular complications in type 2 diabetes. The study aimed to determine whether SGLT2 inhibitors have similar effects in women and men by comparing vascular and safety outcomes to placebo, stratified by sex. The analysis included type 2 diabetes patients from the EMPA‑REG OUTCOME, CANVAS Program, DECLARE TIMI‑58, and CREDENCE trials. SGLT2 inhibitors provided comparable protection against major adverse cardiovascular events, heart failure, vascular death, and total mortality, and similar safety profiles—including amputation, fracture, genital and urinary tract infections—between women and men, with no significant sex interaction.

Abstract

Abstract Sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors prevent cardiovascular complications in type 2 diabetes. We aimed to study whether they have similar effects in women and men by summarizing the effects of SGLT2 inhibitors compared to placebo on vascular and safety outcomes stratified by sex. We included patients with type 2 diabetes enrolled in the EMPA‐REG OUTCOME, CANVAS Program, DECLARE TIMI‐58 and CREDENCE trials. There were no differences in the risk ratios between men and women, SGLT2 versus control (placebo), for vascular efficacy outcomes or death (all P for interaction ≥.12), with clear protection shown against major adverse cardiovascular events, heart failure, vascular death and total mortality. SGLT2 inhibitor treatment was also associated with similar relative risks in women and men for the safety outcomes of amputation, fracture, genital infection and urinary tract infection (all P for interaction ≥.17). SGLT2 inhibition provided similar protection against vascular risks and death, and similar risks of serious adverse events, for women and men.