Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Blood Glucose Levels in Patients with Heart Failure with Reduced Ejection Fraction without Diabetes

Q: What was the study’s primary objective?

To evaluate the impact of SGLT2 inhibitors on blood glucose levels in patients with HFrEF without diabetes.

Q: How was the trial designed and who participated?

A randomized controlled trial including 130 patients with HF in NYHA class II to IV, without diabetes, and with ejection fraction below 40% on echocardiography within the prior three months.

Q: What were the main glycemic and safety findings after three months?

Fasting, postprandial, HbA1c, and random blood glucose decreased significantly, while adverse events were minimal, with no symptomatic hypoglycemia, ketoacidosis, or significant hypotension reported.

Sep 29, 2026

Uploaded by Aurelia

Randomized controlled trial evaluating whether sodium-glucose cotransporter 2 inhibitors (SGLT2) change blood glucose in 130 patients with heart failure with reduced ejection fraction (HFrEF) without diabetes. Participants with NYHA II–IV and echocardiographic ejection fraction <40% received treatment for three months, with repeated clinical and laboratory measures. Results showed improved glycemic control and cardiac function, with minimal adverse events and no symptomatic hypoglycemia, ketoacidosis, or significant hypotension.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction and objectives

Methods

Results

Conclusions

Revista Portuguesa de Cardiologia 45 (2026) 487---496 Revista Portuguesa de Cardiologia Portuguese Journal of Cardiology [www.revportcardiol.org](www.revportcardiol.org) ORIGINAL ARTICLE Impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with heart failure with reduced ejection fraction without diabetes Yasser Ahmed Abd El Hadya, Abd Allah Shahat Ali Abd Elaziz b,􀀂 , Abeer Adly Mahmoud a a Departamento de Cardiologia, Faculdade de Medicina, Universidade Beni-Suef, Beni-Suef, Egypt b Departamento de Cardiologia, Faculdade de Medicina, Universidade Fayoum, Fayoum, Egypt Received 4 August 2025; accepted 15 April 2026 Available online 5 August 2026 KEYWORDS Sodium-glucose cotransporter 2; Blood glucose levels; Heart failure with reduced ejection fraction Abstract Introduction and objectives: Sodium-glucose cotransporter 2 inhibitors (SGLT2) were initially developed as antihyperglycemic agents for the management of type 2 diabetes mellitus (T2DM) . This study sought to evaluate the impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with HFrEF without diabetes. Methods: This randomized controlled trial included 130 patients with HF classiﬁed as NYHA class II to IV and without diabetes, with an ejection fraction (EF) below 40% as determined by echocardiography within the preceding three months. Baseline assessments included serum creatinine, random and fasting blood glucose, 2-hour postprandial glucose, HbA1c, urine acetone, BMI, blood pressure, and serum electrolytes (sodium, potassium, magnesium, ionized calcium, and phosphorus) . After three months of treatment, all these clinical and laboratory parameters were reassessed in both groups. Results: Treatment led to signiﬁcant improvements in cardiac function, including reductions in left ventricular diameters and volumes, and increases in ejection fraction, tricuspid annular plane systolic excursion, and right ventricular fractional area change (p<0.05) . Glycemic control also improved, with signiﬁcant decreases in fasting, postprandial, HbA1c, and random blood glucose (p<0.001) . Serum creatinine, magnesium, and phosphorus levels increased signiﬁcantly (p<0.001) . Adverse events were minimal, with only one patient showing urine acetone positivity (1.5%, p=0.99), and no symptomatic hypoglycemia, ketoacidosis, or signiﬁcant hypotension occurred. Conclusions: SGLT2 inhibitors safely reduce blood glucose in patients with HFrEF without diabetes without causing hypoglycemia, highlighting their potential cardiovascular and metabolic beneﬁts and supporting their use in this population. © 2026 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by-nc-nd/4.0/](licenses/by-nc-nd/4.0/) ) . ∗ Corresponding author. [E-mail address:](E-mail address: abdalashahat407@gmail.com)[ abdalashahat407@gmail.com](E-mail address: abdalashahat407@gmail.com) (A.A.S.A. Abd Elaziz). [https://doi.org/10.1016/j.repc.2026.04.007](https://doi.org/10.1016/j.repc.2026.04.007) 0870-2551/© 2026 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)). PALAVRAS-CHAVE Cotransportador desódio-glicose 2; Níveis de glicosesanguínea; Insuﬁciência cardíaca com frac¸ão de ejec¸ãoreduzida Impacto dos inibidores do cotransportador de sódio-glicose 2 nos níveis de glicosesanguínea em doentes não diabéticos com insuﬁciência cardíaca com fraão deejeão reduzida Resumo Introduão e objetivos: Os inibidores do cotransportador de sódio-glicose 2 (SGLT2) foram inicialmente desenvolvidos como agentes anti-hiperglicémicos para o

FAQs

What was the study’s primary objective?

To evaluate the impact of SGLT2 inhibitors on blood glucose levels in patients with HFrEF without diabetes.

How was the trial designed and who participated?

A randomized controlled trial including 130 patients with HF in NYHA class II to IV, without diabetes, and with ejection fraction below 40% on echocardiography within the prior three months.

What were the main glycemic and safety findings after three months?

Fasting, postprandial, HbA1c, and random blood glucose decreased significantly, while adverse events were minimal, with no symptomatic hypoglycemia, ketoacidosis, or significant hypotension reported.

Sep 29, 2026

Uploaded by Aurelia