Questioning Medicine

Gao FM et al. A systematic review and meta-analysis on the safety and efficacy of sodium–glucose cotransporter 2 inhibitor use in hospitalized patients. Diabetes Care 2024 Dec 1; 47:2275. (https://doi.org/10.2337/dc24-0946) Trial ResultsSGLT-2 inhibitors, crucial in managing diabetes, kidney disease, and heart failure, have shown promising results in hospitalized patients1. The meta-analysis, covering 23 randomized controlled trials with 20,000 participants, revealed:No significant increase in ketoacidosis rates (0.21 vs. 0.14 per 100 person-years)1Lower mortality and fewer readmissions in heart failure patients1Reduced incidence of acute kidney injury overall1These findings suggest that SGLT-2 inhibitors can be safely continued or initiated in hospitalized patients, particularly those with heart failure1.LimitationsHowever, it's important to note some limitations: Potential underpowering: The study might not have had enough statistical power to detect small differences in ketoacidosis rates1. Risk underestim