Effects of sodium glucose cotransporter 2 inhibitors on mineral metabolism in type 2 diabetes mellitus.

In the DECLARE trial, an RCT comparing dapafliglozin with placebo in 17 160 diabetic patients with atherosclerotic cardiovascular disease, the difference in MACE did not reach statistical significance (HR 0.93; 95% CI 0.84–1.03; P = 0.17 for superiority), although patients in the dapagliflozin group had a 0.42% (95% CI; 0.40–0.45) greater reduction in HbA1C compared to patients in the placebo group [ 5 ▪ ].

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A meta-analysis of eight other RCTs showed a trend toward an increased risk of complications from volume depletion with canagliflozin compared to placebo (HR 1.13, CI 0.74–1.73 with 100 mg; HR 1.45, CI 0.98–2.13 with 300 mg) [ 13 ].

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