Use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) was associated with lower mortality in adults with type 2 diabetes mellitus (T2DM), with differences observed across ethnic groups, according to an observational cohort study published in Diabetologia. The analysis evaluated mortality outcomes following the availability of empagliflozin in New Zealand, including prioritised access for Māori and Pacific populations.

The study included 59,505 individuals aged 18-75 years with T2DM from the Auckland and Waikato regions (February 2021 to December 2023), with data linked to national medication-dispensing and mortality records through 2024. After propensity matching, two groups of 12,792 individuals were compared using Cox regression models adjusted for ethnicity, age, gender, medication use, baseline glycated hemoglobin, and cardiovascular and/or renal disease (CVRD) status.

Among individuals with CVRD, annualised mortality rates were lower in those dispensed SGLT2i than in non-users (13.1 vs 35.2 per 1000 person-years). In those without CVRD, corresponding rates were 3.6 versus 7.7 per 1000 person-years. After adjustment, the association between SGLT2i use and lower mortality was greatest in Māori (HR 0.475; 95% CI 0.336–0.672; p<0.001), followed by Pacific (HR 0.507; 95% CI 0.395–0.651; p<0.001) and European populations (HR 0.667; 95% CI 0.545–0.816; p<0.001).

The findings suggested that SGLT2i use was associated with lower mortality across ethnic groups, with larger differences observed in Māori and Pacific populations.