SGLT-2 Inhibition Does Not Affect Risk of Ocular Events

Investigators evaluate the ocular impact of sodium-glucose co-transporter 2 (SGLT-2) inhibition on patients with type 2 diabetes.

Sodium-glucose co-transporter 2 (SGLT-2) inhibition was not correlated with a change in the risk of total ocular events or retinopathy in adult patients with type 2 diabetes, according to study results published in Diabetes Obes Metab.

Placebo and the SGTL-2 inhibitors had about the same risk of total ocular events (relative risks (RR) 0.97; 95% confidence interval (CI) 0.85, 1.11; I2 = 10%, P for heterogeneity =.35) and retinopathy (RR 0.98; 95% CI 0.84, 1.16; I2 = 0%; P for heterogeneity =.45) in the studies. The duration of diabetes, history of retinopathy, history of hypertension, mean/median follow-up time, age, concomitant metformin therapy at study baseline, the selectivity of the SGLT-2 inhibitors and the effect of randomized treatment on HbA1C, systolic blood pressure or body weight (all P >.10) did not affect the risks.

“The absence of any protective effect is somewhat unexpected given SGLT-2 inhibition is associated with improved glycaemic control and lower blood pressure, both of which have been observed to reduce risks of diabetic microvascular disease in prior overviews,” the researchers wrote.

The researchers made these conclusions after performing a systematic review and meta-analysis of 995 records, 183 full-text articles and 9 randomized, placebo-controlled trials (3 canagliflozin trials, 3 dapagliflozin trials, 2 ipragliflozin trials and 1 empagliflozin trial). These amounted to evaluating data from a total of 39,982 patients and 1414 total ocular events, which included 624 retinopathy events.

They noted that inconsistency of diagnostic and reporting criteria, underreporting of eye events and limited baseline history of ocular disease that may have appeared in the included studies may have impacted their findings.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Li C, Zhou Z, Neuen B, et al. Sodium-glucose co-transporter-2 inhibition and ocular outcomes in patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. Published online September 21, 2020. doi: 10.1111/dom.14197