Role of SGLT2 Inhibitors in Diabetic Retinopathy

Objectives: To determine the role of SGLT2 Inhibitors in diabetic retinopathy by comparing the incidence and severity of retinopathy in patients using SGLT2 inhibitors with those using other antidiabetic therapies. Study design: Case-control study. Place and duration of study: This study was conducted at the department of Medicine, PAF Hospital, Islamabad from Apr 2024-March 2025. Methods: A total of 300 type 2 diabetic patients using SGLT2 inhibitors (Dapagliflozin, Empagliflozin) for at least 3 consecutive years with HbA1c ≤7.5% were included as the study group. Another 300 patients on non-SGLT2 antidiabetic regimens, matched for treatment duration and glycemic control, were included as the control group. Primary objective was set as the incidence and severity of diabetic retinopathy. These primary outcomes were compared between the two groups to find the role of SGLT2 Inhibitors in diabetic retinopathy. Results: The mean age in this study was 53.76 ± 8.82 years (ranged from 34 to 70 years). Comparison of the incidence and severity showed a significantly lower incidence of diabetic retinopathy (˂0.01), non-proliferative retinopathy (p=0.02) and proliferative retinopathy (p=0.04) in the study group compared to the control group. However, difference was non-significant for the presence of advanced retinopathy or macular abnormalities (p=0.78). Conclusion: SGLT2 inhibitors demonstrated substantial preventive benefits in reducing the incidence and progression of diabetic retinopathy compared to other antidiabetic therapies, particularly for non-proliferative and proliferative retinopathy stages.