Are SGLT-2 Inhibitors Safe and Effective in Hospitalized Patients?

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors have become important in managing patients with diabetes, kidney disease, and heart failure, but little is known about their risks and benefits in hospitalized patients. A chief concern is ketoacidosis, which can develop after acute infection and reduced oral intake — both commonly seen in hospitalized patients. Furthermore, euglycemic ketoacidosis is more likely to be missed than its hyperglycemic counterpart.

Researchers performed a meta-analysis of 23 randomized, controlled trials that involved 20,000 hospitalized patients (30% with diabetes) to compare outcomes between those who received SGLT-2 inhibitors and those who did not. Ketoacidosis rates were slightly, but not significantly, hig…