SGLT-2 Inhibitors: From Real-World Insights to Mechanistic and Oncological Frontiers - report from EASD 2026

Uh, SGLT2 inhibitors have been used for, uh, many, over the 10 years now, uh, in, uh, in the clinical, uh, management of, of patients with diabetes.

And, um, as, uh, they are used in, uh, in the real world, a new application are, are revealing themselves, um, a- and, uh, a new area of, of, uh, efficacy are, are being discovered.

Uh, SGLT2 inhibitors have been introduced for diabetes because, uh, they block glucose reuptake in the kidney, so they induce glycosuria.

Uh, in this way, they create a, a calorie loss, uh, in, and energy deficit, uh, in the body that the body compensates by, by, um, producing more sugar in the liver.

Um, so they've been effective in reducing, uh, blood glucose in, uh, in diabetic patients.

Uh, and, um, this, uh, this mechanism of action is directly linked with- to some of the side effects that, uh, that have been observed, including ur- increased frequency of uni- rani- urinary tract infections and dehydration.

Uh, because if you have more glucose in the urine, of course you're going to have more, an environment that, uh, that favors the proliferation of bacteria.

Um, uh, the, the side effects that, uh, that, uh, there are also side effects that are a little, um, more, more, um, serious, like ketoacidosis and sepsis.

Uh, however, these are very, uh, very rare.

And, uh, the side effects, of course, have been, uh, have been one of the causes for discontinuation of SGLT2 inhibitors.

And, uh, one of the, uh, of the talks that are, that have been presented here, uh, shows that, uh, the discontinuation has, has been more, um, more, uh, uh, pre- prevalent in older patients and in patients with low socioeconomic status.

Um, other things that have been discussed is the use of SGLT2 inhibitors also in Type 1 diabetes, where, uh, they have been shown to, uh, to, um, be effective in reducing bloo- blood glucose, and, uh, they have caused, uh, consistently, uh, ketonemia.

However, most times not in, uh, at levels that are, that are worrisome.

Uh, so, um, one of the, the main focus of the, of the, uh, of this session was also to, uh, talk about, um, the, the emerging, uh, applications of SGLT2 inhibitors, including, uh, uh, applications for cardiovascular disease and for chronic kidney disease.

And, um, one of the, uh, so, um, they are already approved now for, for heart failure and for chronic kidney disease, where they can, um, help patients, uh, with, with these problems.

Uh, SGLT2 inhibitors have been used for, uh, many, over the 10 years now, uh, in, uh, in the clinical, uh, management of, of patients with diabetes.

And, um, as, uh, they are used in, uh, in the real world, a new application are, are revealing themselves, um, a- and, uh, a new area of, of, uh, efficacy are, are being discovered.

Uh, SGLT2 inhibitors have been introduced for diabetes because, uh, they block glucose reuptake in the kidney, so they induce glycosuria.

Uh, in this way, they create a, a calorie loss, uh, in, and energy deficit, uh, in the body that the body compensates by, by, um, producing more sugar in the liver.

Um, so they've been effective in reducing, uh, blood glucose in, uh, in diabetic patients.

Uh, and, um, this, uh, this mechanism of action is directly linked with- to some of the side effects that, uh, that have been observed, including ur- increased frequency of uni- rani- urinary tract infections and dehydration.

Uh, because if you have more glucose in the urine, of course you're going to have more, an environment that, uh, that favors the proliferation of bacteria.

Um, uh, the, the side effects that, uh, that, uh, there are also side effects that are a little, um, more, more, um, serious, like ketoacidosis and sepsis.

Uh, however, these are very, uh, very rare.

And, uh, the side effects, of course, have been, uh, have been one of the causes for discontinuation of SGLT2 inhibitors.

And, uh, one of the, uh, of the talks that are, that have been presented here, uh, shows that, uh, the discontinuation has, has been more, um, more, uh, uh, pre- prevalent in older patients and in patients with low socioeconomic status.

Um, other things that have been discussed is the use of SGLT2 inhibitors also in Type 1 diabetes, where, uh, they have been shown to, uh, to, um, be effective in reducing bloo- blood glucose, and, uh, they have caused, uh, consistently, uh, ketonemia.

However, most times not in, uh, at levels that are, that are worrisome.

Uh, so, um, one of the, the main focus of the, of the, uh, of this session was also to, uh, talk about, um, the, the emerging, uh, applications of SGLT2 inhibitors, including, uh, uh, applications for cardiovascular disease and for chronic kidney disease.

And, um, one of the, uh, so, um, they are already approved now for, for heart failure and for chronic kidney disease, where they can, um, help patients, uh, with, with these problems.