From the Research
SGLT2 inhibitors are associated with a lower risk of diabetic retinopathy progression in patients with type 2 diabetes, as evidenced by the most recent and highest quality study published in 2024 1. The protective effect of SGLT2 inhibitors on retinopathy appears to stem from multiple mechanisms, including improved glycemic control, reduced inflammation, decreased oxidative stress, and improved vascular function. Additionally, SGLT2 inhibitors provide renoprotective effects, which indirectly benefit retinal health since kidney and eye complications often progress in parallel in diabetes. Some key points to consider when prescribing SGLT2 inhibitors for patients with type 2 diabetes include:
- The risk of sight-threatening retinopathy is lower with SGLT2 inhibitors compared to other glucose-lowering therapies, such as dipeptidyl peptidase-4 inhibitors and sulfonylureas 2, 1.
- SGLT2 inhibitors, including empagliflozin and canagliflozin, have been shown to reduce the progression of retinopathy in patients with type 2 diabetes 3, 4.
- Regular eye examinations are still necessary for patients starting SGLT2 inhibitors, as recommended for all diabetes patients, to monitor for any retinopathy development or progression.
- The benefits of SGLT2 inhibitors on retinopathy outcomes are supported by real-world evidence and clinical trials, which have generally shown neutral to beneficial effects on retinopathy outcomes 5, 1.