Impact of sodium-glucose cotransporter-2 inhibitors on quality of life and patient-reported outcomes in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

Document Type

Review Article

Department

Medical College Pakistan

Abstract

Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve glycemic and cardiovascular outcomes in type 2 diabetes mellitus (T2DM). However, their impact on quality of life (QoL) and patient-reported outcomes (PROs) has not been systematically evaluated. We conducted a systematic review and meta-analysis to assess the effect of SGLT2 inhibitors on QoL in patients with T2DM.
Methods: MEDLINE, Embase, Scopus, Cochrane and ClinicalTrials.gov were searched until 18 August 2025 for randomised controlled trials and post hoc analyses of SGLT2 inhibitors reporting validated QoL or PRO outcomes in adults with T2DM. A random-effects model was used to estimate mean differences (MD) or odds ratios (OR) with 95% CIs. Subgroup analyses compared SGLT2 inhibitors with placebo and active comparators. Risk of bias was assessed using the Cochrane RoB-2 tool.
Results: Ten studies including 5294 patients (SGLT2i: 2807; control: 2487) were included. SGLT2 inhibitors significantly improved: EQ-5D Index score versus placebo (MD: 0.04, p = 0.008), DTR-QoL against active comparators (MD: 6.99; p = 0.0006), DTSQ compared to active comparators (MD: 0.54; p = 0.006) and IWQoL (MD: 1.44; p = 0.005) versus placebo. Improvements were also observed in SHIELD WQ-9 overall QoL (OR: 2.11; p = 0.005), emotional health (OR: 2.16; p = 0.006), self-esteem (OR: 2.26; p = 0.006) and work performance (OR: 1.99; p = 0.04) compared with placebo.
Conclusion: Randomised evidence suggests SGLT2 inhibitors enhance EQ-5D Index score, diabetes-specific QoL and several PROs in T2DM, particularly in physical, emotional and treatment satisfaction domains, supporting their earlier use in this population.

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Publication (Name of Journal)

Diabetes Obes Metab

DOI

10.1111/dom.70714

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