In adults with type 2 diabetes mellitus (T2DM), long-term exposure to antidiabetic therapies has raised questions about potential associations with cancer risk and survival outcomes. In Diabetes, Metabolic Syndrome and Obesity, a retrospective cohort analysis evaluated the association between sodium-glucose cotransporter 2 inhibitor (SGLT2) use and tumor development in patients with T2DM.

The study included 350 patients treated between January 2021 and January 2025. Of these, 189 received SGLT2 inhibitors, while 161 were treated with other antidiabetic medications. Clinical characteristics, glycemic control, cumulative drug exposure, and incidence of lung, colorectal, prostate, breast, bladder, hepatic, and ovarian cancers were assessed. Kaplan-Meier methods were used to evaluate cancer incidence and mortality outcomes.

Overall tumor incidence was significantly lower in the SGLT2 inhibitor group than in the control group (P<0.001), driven primarily by lower rates of lung cancer (P=0.018) and ovarian cancer (P=0.017). Smoking, alcohol consumption, and poor glycemic control were associated with higher overall and site-specific tumor risk. The SGLT2 inhibitor group showed lower fasting blood glucose, glycated hemoglobin, low-density lipoprotein cholesterol, total cholesterol, and triglycerides, along with higher high-density lipoprotein cholesterol (all P<0.05). Renal markers favored the SGLT2 inhibitor group, with lower blood urea nitrogen and creatinine and higher estimated glomerular filtration rate (all P<0.001). Kaplan-Meier analyses showed longer progression-free and overall survival in the SGLT2 inhibitor group (both P<0.01).

These findings show an association between SGLT2 inhibitor use and lower tumor incidence, alongside improved metabolic profiles and survival outcomes in T2DM.