# Association Between Sodium–Glucose Cotransporter‐2 Inhibitors and Sepsis Risk in Patients With Type 2 Diabetes Mellitus

## TL;DR

This study finds that a diabetes drug called SGLT2 inhibitors lowers the risk of sepsis and related complications compared to another drug in type 2 diabetes patients.

## Contribution

The study provides new evidence that SGLT2 inhibitors are associated with reduced sepsis risk compared to DPP-4 inhibitors in type 2 diabetes patients.

## Key findings

- SGLT2i users had a 23% lower risk of sepsis compared to DPP-4i users.
- SGLT2i users had a 30% lower risk of septic shock and a 40% lower mortality risk.
- Findings suggest SGLT2i may offer protective benefits against sepsis in T2DM patients.

## Abstract

This retrospective study is aimed at evaluating the effect of SGLT2 inhibitors (SGLT2i) on the risk of sepsis among patients with Type 2 diabetes mellitus (T2DM).

An active‐comparator new user design was utilized based on Taiwan′s National Health Insurance Research Database. Adult patients diagnosed with T2DM between 2017 and 2020 who initiated either SGLT2i or DPP‐4 inhibitors (DPP‐4i) were included. After 1:2 matching by age, sex, and Charlson Comorbidity Index, the study enrolled 34,672 SGLT2i users and 69,344 DPP‐4i users. The primary outcome was sepsis, with secondary outcomes including septic shock, organ dysfunction, and mortality. Hazard ratios (HRs) were estimated using Cox proportional hazards regression.

SGLT2i users had a significantly lower risk of sepsis than DPP‐4i users (10.1% vs. 15.5%; adjusted HR [aHR]: 0.77; 95% CI: 0.74–0.81). The risk of septic shock and mortality in SGLT2i users was also reduced by 30% (aHR: 0.70; 95% CI: 0.57–0.87) and 40% (aHR: 0.60; 95% CI: 0.54–0.66), respectively, compared with that of DPP‐4i users.

The findings suggest that SGLT2i is associated with a significantly lower risk of sepsis, septic shock, and mortality compared with that of DPP‐4i in patients with T2DM.