An Overview of the Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Hematological Parameters in Diabetic Patients

Abstract

Background: Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT2-IS) have been shown to increase hemoglobin (Hb) levels, hematocrit, and erythrocyte count. It has also been found that these agents can potentially reduce the risk of anemia and minimize the need for erythropoiesis stimulating agents (ESA) and other treatments in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). However the precise mechanism for such an effect is still conflicting. Aim: We aimed at providing an overview of the effects of SGLT2-IS on hematological parameters, specifically focusing on their potential to improve anemia and erythropoiesis in patients with diabetes mellitus (DM). Additionally the proposed mechanisms by which SGLT2-IS may improve Hb levels besides their clinical importance and future directions will also be highlighted. Results: Based on the obtained data from latest literatures, SGLT2-IS may improve the status of anemia and other linked abnormalities via their mild diuretic potential, effects on erythropoietin (EPO) production, and possible increase in renal oxygen delivery. Conclusion: SGLT2-IS may have a promising role in improving multiple aspects of blood, circulatory and renal systems health in patients with DM, beyond their primary glucose-lowering role.