Initiation of sodium-glucose cotransporter-2 (SGLT2) inhibitors lowered all-cause death in adults with type 2 diabetes (T2D) receiving systemic glucocorticoids. Data from the European Association for the Study of Diabetes (EASD) 2025 show these findings are based on a global real-world cohort.

The study included 9,090 propensity-score matched patients (3,906 women; mean age 60.1 years; mean estimated glomerular filtration rate 82.4 mL/min/1.73 m²) treated with oral glucocorticoids. Compared with dipeptidyl peptidase-4 (DPP4) inhibitors, SGLT2 inhibitors were associated with lower all-cause death (7.8% vs 10.7%; rate ratio 0.73, 95% confidence interval 0.64–0.84) and a reduced risk of a composite kidney outcome including chronic kidney disease stage 4 or worse, dialysis initiation, or eGFR <30 mL/min/1.73 m² (10.4% vs 12.8%; rate ratio 0.81, 95% CI 0.72–0.92). Safety outcomes, including diabetic ketoacidosis and genital tract infections, were similar between groups.

These results suggest that SGLT2 inhibitors may provide mortality and kidney protection for adults with T2D receiving systemic glucocorticoids, supporting broader use in this population.