The Impact of SGLT2 Inhibitors on Hemoglobin Levels in Type 2 Diabetes: Potential Benefits Beyond Glycemic and Renal Outcomes

Abs tractAim: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic agents with proven cardiovascular and renal benefits.Recent evidence suggests they may also increase hemoglobin (Hb) levels through mechanisms beyond hemoconcentration.This study aimed to evaluate the effect of SGLT2 inhibitors on Hb levels in type 2 diabetes mellitus (T2DM) patients without anemia or advanced kidney disease. Methods:The data of 12,511 patients who attended the diabetes outpatient clinic between November 2023 and March 2025 were scanned retrospectively.Among them, 216 T2DM patients were analyzed; 130 were using SGLT2 inhibitors (dapagliflozin or empagliflozin).Laboratory and demographic data were compared between users and non-users.Correlation and multivariate linear regression analyses were performed.Results: Hemoglobin levels were significantly higher in SGLT2 inhibitor users than non-users (14.441.23 vs. 13.761.12g/dL, p<0.001).This effect was consistent across SGLT2 agents and independent of glycemic control, renal function, or liver enzymes.Male gender and serum creatinine were also positive predictors of Hb levels.Hemoconcentration alone could not explain the increase in Hb and may reflect improved erythropoiesis via renal mechanisms. Conclusion:Sodium-glucose cotransporter 2 inhibitor use is associated with elevated Hb levels in T2DM patients, supporting their potential role in anemia prevention in the course of chronic diseases.