Sodium Glucose Co-Transporter 2 Inhibitors Use in Diabetic Patients with Cirrhosis Improves Liver-related Outcomes and Survival
In brief
SGLT2 inhibitors lower death risk by 31% in diabetics with cirrhosis
In a propensity-matched cohort of over 14,000 diabetic patients with cirrhosis, SGLT2-inhibitor use reduced one-year hepatic decompensation from 12.5% to 9.9% and cut overall mortality by roughly one-third. Rates of liver cancer were also lower. Findings come from two large databases, but randomized trials are still needed to confirm benefit.
- Journal
- Clinical and translational gastroenterology (Q1)
- Published
- 6 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Sajid Jalil, Khurram Bari, Khalid Mumtaz, Ahmed Ibrahim, Talal K Bhatti, Suvisesh Pothuraju, et al.
- PMID
- 42561405
- DOI
- 10.14309/ctg.0000000000001078
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 9 August 2026): Large retrospective cohort, liver outcomes in cirrhosis
- Picked for Endocrinology, Diabetes and Metabolism (top studies of the week, 9 August 2026).
- Picked for Hepatology (top studies of the week, 9 August 2026).
Abstract
BACKGROUND: The liver outcomes of SGLT-2 inhibitor (SGLT-2i) in T2DM patients with cirrhosis have not been well studied. METHODS: We conducted a retrospective cohort study (January 1, 2010-December 31, 2025) using two databases. Adults ≥ 18 years with type 2 diabetes mellitus (T2DM) and cirrhosis newly treated with SGLT-2i were identified. Patients were grouped into those receiving SGLT-2i and those not receiving SGLT-2i. Baseline characteristics were compared before and after propensity score matching. The primary outcome was the incidence of hepatic decompensation among SGLT-2i users versus non-users. RESULTS: The intervention group consisted of 14,231 SGLT-2i users and the control group consisted of 249,746 non-SGLT-2i users. After 1:1 PSM, use of SGLT-2i was associated with reduced composite outcome of hepatic decompensation compared to control group at 1 year (9.9% vs. 12.5%, p=0.001), at 3 years (16.4% vs. 18.1%, p<0.001) and 5 years (19.9% vs 21.9%, p<0.001). HCC rates were significantly lower in the SGLT-2i users at 1 year (2.3% vs. 3.5%, p=0.001), at 3 years (2.9% vs. 4.2%, p=0.001) and at 5 years (3.4% vs. 4.8%, p=0.001). There was a 31% reduction in mortality in the SGL-T2i arm (HR: 0.69; CI: 0.56- 0.83, p<0.001), as compared to the non-SGLT-2i arm.These findings were validated in the EVERSANA database. CONCLUSIONS: Use of SGLT-2i was associated with a reduced composite outcome of hepatic decompensation and mortality among patients with T2DM and cirrhosis compared with non-SGLT-2i users across two independent datasets. Prospective randomized controlled trials are needed to confirm these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.