医療法人社団岡田会

Aim:Sodium-glucose contransport 2(SGLT2)inhibitors are antidiabetic drugs with proven cardiovascular and renal benefits. Recent evidence suggests that SGLT2 inhibitors may also increase hemoglobin(Hb) levels through mechanisms other than hemoconcentration. To investigate the effects of SGLT2 inhibitors on Hb levels in patients with type 2 diabetes mellitus(T2DM) without anemia or advanced renal disease.

Methods:We retrospectively analyzed data from 2,122 patients admitted to our hospital between August 2020 and September 2025. Patients were required to have:1)type 2 diabetes;2)age 18 years or older;3)hemoglobin levels ≧12g/dL for women and ≧13g/dL for men;and4) eGFR≧30mL/min/1.73 m2. However, patients with the following conditions were excluded:(a) vitamin B12 deficiency;(b) receiving iron supplements;(c) receiving erythropoietin preparations;or(d) concomitant hematological malignancies.

Laboratory and demographic data were compared between SGLT2 inhibitor users and non-users.

Results:The analysis included 140 patients with type 2 diabetes.

37 of those were using SGLT2 inhibitors. Hemoglobin levels were significantly higher in SGLT2 inhibitor users compared with non-users (14.35±1.07g/dL vs. 13.47±1.34g/dL,p=0.0002).There were no statistically significant differences in HbA1c,eGFR,or urea/creatinine between the two groups.

Conolusion:The use of sodium-glucose cotranspoter 2 inhibitors was associated with elevated hemoglobin levels in patients with type 2 diabetes, even in the absence of anemia, independent of glycemic control, renal function, or hemoconcentration. Hemoconcentration alone cannnot explain the elevated hemoglobin levels, which may reflect improved red blood cell production via renal mechanisms. This suggests a potential role in preventing anemia during the course of chronic disease.