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Background <p>Diabetic retinopathy (DR) is a leading cause of vision loss among individuals with type 2 diabetes mellitus (T2DM), necessitating effective interventions to prevent disease progression. This systematic review was conducted to evaluate the potential role of sodium-glucose co-transporter 2 (SGLT2) inhibitors as predictive factors of DR.</p> Methods <p>A comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases was conducted up to December 8, 2024, following PRISMA guidelines. Studies reporting DR outcomes among SGLT2 inhibitor users compared to other glucose-lowering therapies were included.</p> Results <p>Sixteen cohort studies involving over 400,000 participants were included. SGLT2 inhibitors significantly reduced the risk of DR progression compared to other treatments (HR: 0.75; 95% CI: 0.67–0.85; <i>p</i> &lt; 0.001), despite substantial heterogeneity (I<sup>2</sup> = 82.89%). Subgroup analyses showed significant benefits over DPP-4 inhibitors, GLP-1 receptor agonists, and Sulfonylureas. For incident DR, pooled data from eight studies demonstrated a modest but significant risk reduction (HR: 0.87; 95% CI: 0.79–0.97; <i>p</i> = 0.01; I<sup>2</sup> = 74.9%). Subgroup analysis indicated benefit over DPP-4 inhibitors but not over GLP-1 RAs or placebo. No publication bias was detected (Egger’s test <i>p</i> = 0.76), and sensitivity analyses confirmed the stability of results.</p> Conclusions <p>SGLT2 inhibitors significantly reduce the progression and incidence of diabetic retinopathy, underscoring their potential as a key component in comprehensive diabetes management. Further high-quality, long-term randomized trials are warranted to confirm these findings and elucidate underlying mechanisms.</p>

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SGLT2 inhibitors for delaying diabetic retinopathy: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Saba Goodarzi,
  • Faezah Soltani Abhari,
  • Gelareh Azarinoush,
  • Mohammd Ali Rafiei,
  • Hessam Yousefian,
  • Ehsan Heidari,
  • Edris Ekramipour,
  • Afshin Mirzaei,
  • Kosar Namakin,
  • Arman Shafiee

摘要

Background

Diabetic retinopathy (DR) is a leading cause of vision loss among individuals with type 2 diabetes mellitus (T2DM), necessitating effective interventions to prevent disease progression. This systematic review was conducted to evaluate the potential role of sodium-glucose co-transporter 2 (SGLT2) inhibitors as predictive factors of DR.

Methods

A comprehensive search of PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases was conducted up to December 8, 2024, following PRISMA guidelines. Studies reporting DR outcomes among SGLT2 inhibitor users compared to other glucose-lowering therapies were included.

Results

Sixteen cohort studies involving over 400,000 participants were included. SGLT2 inhibitors significantly reduced the risk of DR progression compared to other treatments (HR: 0.75; 95% CI: 0.67–0.85; p < 0.001), despite substantial heterogeneity (I2 = 82.89%). Subgroup analyses showed significant benefits over DPP-4 inhibitors, GLP-1 receptor agonists, and Sulfonylureas. For incident DR, pooled data from eight studies demonstrated a modest but significant risk reduction (HR: 0.87; 95% CI: 0.79–0.97; p = 0.01; I2 = 74.9%). Subgroup analysis indicated benefit over DPP-4 inhibitors but not over GLP-1 RAs or placebo. No publication bias was detected (Egger’s test p = 0.76), and sensitivity analyses confirmed the stability of results.

Conclusions

SGLT2 inhibitors significantly reduce the progression and incidence of diabetic retinopathy, underscoring their potential as a key component in comprehensive diabetes management. Further high-quality, long-term randomized trials are warranted to confirm these findings and elucidate underlying mechanisms.