SGLT2 Inhibitors Linked to Lower Anemia Risk in Type 2 Diabetes, Suggests Study

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2025-09-05 03:30 GMT | Update On 2025-09-05 03:30 GMT

Germany: Researchers have found in a new study of 28,441 patients with type 2 diabetes that SGLT2 inhibitors were associated with a 33% reduced risk of iron deficiency anaemia compared to DPP-4 inhibitors. Further, the protective effect was more significant in men and in patients aged 61 and older.

The study, published in Diabetes, Obesity and Metabolism, was conducted by Dr. Theresia Sarabhai and Dr. Karel Kostev in Germany. It explored whether sodium–glucose cotransporter-2 inhibitors (SGLT2i), a class of drugs widely used for type 2 diabetes, influence the risk of developing iron deficiency anemia (IDA), a frequent comorbidity in this patient population. Previous research has suggested that SGLT2 inhibitors may affect erythropoiesis and iron metabolism, but clear clinical evidence has been lacking.

To address this, the researchers carried out a retrospective cohort study using data from the German IQVIA Disease Analyzer, a database of electronic medical records from office-based practices. Eligible participants were adults with type 2 diabetes who started therapy with either SGLT2 inhibitors or dipeptidyl peptidase-4 inhibitors (DPP-4i) between 2012 and 2022, in combination with metformin. Patients with prior diagnoses of anaemia were excluded.

Propensity score matching was applied to ensure comparability between groups based on age, sex, baseline HbA1c levels, metformin duration, and anemia-related comorbidities. This yielded 28,441 patients in each cohort, with a mean age of 64.3 years and 36.5% women. Follow-up extended for up to five years or until a diagnosis of IDA, a change in antidiabetic therapy, loss to follow-up, or study end.

The study led to the following findings:

The 5-year cumulative incidence of iron deficiency anaemia was 6.9% in the SGLT2 inhibitor group compared with 11.3% in the DPP-4 inhibitor group.
SGLT2 inhibitor therapy was linked to a 33% lower risk of iron deficiency anaemia (HR, 0.67).
The protective effect was stronger in men than in women.
Patients aged over 60 years showed a significant benefit.
Among men aged 51–70 years, the protective effect was most pronounced.
The benefit of SGLT2 inhibitors was seen mainly in patients with shorter durations of metformin use (less than three years).

The authors noted that these results highlight potential hematologic benefits of SGLT2 inhibitors, beyond their established role in glycaemic control and cardiovascular protection. “These data highlight a favorable effect on iron homeostasis, particularly in selected subgroups,” they wrote.

However, the study has limitations. As an observational analysis, it cannot establish causation. Other factors, such as socioeconomic status, were not assessed, and the absence of laboratory-confirmed anemia markers may have led to underdiagnosis. Over-the-counter supplementation with iron, vitamin B12, or folate was also not captured in the dataset.

"Despite these constraints, the findings add to real-world evidence supporting a broader role for SGLT2 inhibitors in managing complications of type 2 diabetes. The association with a lower incidence of iron deficiency anaemia, especially among older men, warrants further investigation in randomized clinical trials to determine whether these benefits translate into improved patient outcomes," the authors concluded.

Reference:

Sarabhai T, Kostev K. SGLT2 inhibitor therapy and lower incidence of iron deficiency anaemia in patients with type 2 diabetes: A retrospective cohort study from Germany. Diabetes Obes Metab. 2025 Aug 22. doi: 10.1111/dom.70057. Epub ahead of print. PMID: 40843651.

Article Source : Diabetes, Obesity and Metabolism

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Medha Baranwal

Comments Policy

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

SGLT2 Inhibitors Linked to Lower Anemia Risk in Type 2 Diabetes, Suggests Study

Similar News

Tirzepatide and Other GLP-1 Receptor Agonists Show Promise in Cardiometabolic HFpEF: JAMA

Women With Metabolic Syndrome Face Higher Odds of Overactive Bladder: Study

HOMA-IR Identified as Independent Predictor of Liver Fibrosis in MAFLD, suggests study

People with learning disabilities seem to progress faster to severe type 2 diabetes, reveals research

Postmenopausal Women with T1D Face Glucose Regulation Changes and severe menopausal symptoms: Study

Alopecia Areata Linked to Autoimmune Thyroid Diseases, Suggests Study

Sharp Weight Loss from Childhood to Adulthood May Raise Glaucoma Risk: Study Shows