Evidence mapPaperPMID 41811498Full record

ReviewEuropean journal of clinical pharmacology2026

Beyond safety: adverse events and unanticipated advantages of SGLT2 inhibitors.

Lorenzo Falsetti, Nicola Tarquinio, Luciano Mucci, Silvia Santini, Emanuele Guerrieri, Laura Giovenali, Giulia Pierdomenico, Vincenzo Zaccone, Giovanna Viticchi, Gianluca Moroncini

Abstract readReview
In one paragraph

Review in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lorenzo FalsettiDipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy. l.falsetti@staff.univpm.it.
Nicola TarquinioDipartimento Percorsi Medici, U.O.C. Medicina Interna, INRCA-IRCCS, Presidio Ospedaliero di Osimo, Ancona, Italy.
Luciano MucciUOC Medicina Interna, Ospedale Santa Maria della Misericordia Urbino, Azienda Sanitaria Locale 1, Pesaro-Urbino, Italy.
Silvia SantiniScuola di Specializzazione in Medicina d'Emergenza-Urgenza, Università Politecnica delle Marche, Ancona, Italy.
Emanuele GuerrieriScuola di Specializzazione in Medicina d'Emergenza-Urgenza, Università Politecnica delle Marche, Ancona, Italy.
Laura GiovenaliPronto Soccorso, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliero-Universitaria Delle Marche, Ancona, Italy.
Giulia PierdomenicoScuola di Specializzazione in Medicina d'Emergenza-Urgenza, Università Politecnica delle Marche, Ancona, Italy.
Vincenzo ZacconeDipartimento di Emergenza-Urgenza, Medicina Interna Generale e Subintensiva, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
Giovanna ViticchiDipartimento di Medicina Sperimentale e Clinica, Università Politecnica delle Marche, Ancona, Italy.
Gianluca MoronciniDipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSodium-glucose transporter 2 inhibitors (SGLT2i) are widely used for diabetes management and have demonstrated benefits in treating acute and chronic heart failure (HF) and chronic kidney disease (CKD). Their increasing application has revealed various side effects, although only a few are currently recognized as drug-related adverse events, based on ongoing observations.

aimsThis review synthesizes positive and negative side effects linked to SGLT2i and proposes management strategies.

methodsA literature search of PubMed/EMBASE, Web of Science, and Google Scholar from the past 10 years identified randomized trials, meta-analyses, observational cohorts, and pharmacovigilance studies reporting SGLT2i-related events across genitourinary, endocrine, metabolic, hematologic, skeletal, and vascular domains.

resultsData indicate an increased incidence of genital infections (GIs) in diabetic subjects, while associations with urinary tract infections (UTIs) are less consistent. Non-diabetic HF/CKD patients show modest increases in GIs and UTIs. SGLT2i modestly increase hematocrit and may reveal clonal erythrocytosis. Rare conditions like Fournier’s gangrene have been reported, though without a clearly increased risk in clinical trials: all the reported cases led to drug discontinuation. There is no conclusive evidence linking SGLT2i to fractures or osteoporosis, and risk of lower-limb amputation appears comparable to DPP-4 inhibitors, with some trend compared to GLP-1 receptor agonists, suggesting caution in patients with peripheral artery disease. Observational data suggest SGLT2i may protect against syncope and reduce acute kidney injury.

conclusionsOverall, SGLT2i are safe, with manageable adverse events such as GIs and UTIs. A thorough understanding of potential complications is essential for clinicians to optimize patients’ management.

Indexed as

Diabetes Mellitus, Type 2Sodium-Glucose Transporter 2 InhibitorsHumansSodium-Glucose Transporter 2 InhibitorsAcute kidney injuryAdverse eventsAmputationChronic kidney diseaseErythrocytosisFracturesGenitourinary infectionsHeart failureKetoacidosisSGLT2 inhibitors

Identifiers

PMID41811498
PMCPMC12979277

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.