What is the relationship between Necrotizing Enterocolitis and Sodium-Glucose Linked Transporter 2 (SGLT2) inhibitors?

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Last updated: February 26, 2025View editorial policy

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From the Research

There is no established direct relationship between SGLT2 inhibitors and necrotizing enterocolitis (NEC). Necrotizing enterocolitis is primarily a condition affecting premature infants, characterized by inflammation and death of intestinal tissue. It is not typically associated with SGLT2 inhibitors, which are medications used to treat type 2 diabetes in adults by preventing glucose reabsorption in the kidneys. SGLT2 inhibitors (such as empagliflozin, canagliflozin, and dapagliflozin) work by blocking sodium-glucose cotransporter-2 in the kidneys, causing excess glucose to be excreted in urine. The main side effects of SGLT2 inhibitors include urinary tract infections, genital mycotic infections, and volume depletion. In rare cases, they can cause more serious effects like diabetic ketoacidosis or Fournier's gangrene, but they are not known to cause intestinal necrosis conditions like NEC, as supported by studies such as 1 and 2.

Key Points to Consider

  • Necrotizing enterocolitis is a condition that primarily affects premature infants, and its etiology remains obscure despite over 40 years of research, as noted in 3.
  • SGLT2 inhibitors are used to treat type 2 diabetes in adults and have been shown to have cardiovascular benefits, as seen in 1 and 2.
  • The main side effects of SGLT2 inhibitors do not include intestinal necrosis conditions like NEC.
  • If there are concerns about gastrointestinal effects of diabetes medications, alternative classes such as metformin, GLP-1 receptor agonists, or DPP-4 inhibitors could be considered after consultation with a healthcare provider.

Recent Research on NEC

Recent studies, such as 4 and 5, have focused on the diagnosis and treatment of NEC, as well as potential new biomarkers and therapeutics. However, these studies do not establish a direct relationship between SGLT2 inhibitors and NEC.

Clinical Implications

In clinical practice, the use of SGLT2 inhibitors should not be avoided due to concerns about NEC, as the condition is not typically associated with these medications. Instead, healthcare providers should consider the individual patient's risk factors and medical history when prescribing diabetes medications, as suggested by 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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