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HEMATOLOGY DEPARTMENT, Faculty of Medicine, Cukurova University , Adana , Turkey
Internal Medicine Department, Düziçi State Hospital Turkey
SGLT-2 inhibitors have been associated with increases in hemoglobin and hematocrit levels; however, the independence of this effect from confounding factors remains unclear in real-world settings. This study aimed to determine whether hemoglobin and hematocrit levels differed between patients with type 2 diabetes mellitus using SGLT-2 inhibitors and the control group and to investigate whether this effect was independent of factors such as age, sex, ferritin level, glycemic control, and renal function. Data were retrospectively collected from 205 adult patients at the Internal Medicine Clinic of Düziçi State Hospital. Patients were divided into two groups: those using an SGLT-2 inhibitor for at least three months (n = 103) and the control group (n = 102). Hemoglobin, hematocrit, ferritin, HbA1c, and eGFR levels were compared. Subgroup analyses and propensity score matching (PSM) were performed. Median hemoglobin (14.90 (12.6–18.2) vs. 13.00 (12.0–16.06) g/dL, p < 0.001) and hematocrit (45.20 (37.6–54.1) vs. 40.00 (32.2–49.6)%, p < 0.001) were significantly higher in the SGLT-2 group. This increase remained significant across all subgroups (sex, age, ferritin, HbA1c) and persisted after PSM (p < 0.001). Higher hematological parameters were observed with a treatment duration of ≥12 months. SGLT-2 inhibitors are associated with significantly higher hemoglobin and hematocrit levels in patients with type 2 diabetes, independent of iron stores and glycemic control. The underlying mechanism likely involves increased erythropoiesis beyond hemoconcentration. Periodic hematological monitoring is recommended.
Conceptualization, A.T.; Data curation, A.T. and M.S.B.; Formal Analysis, A.T.; Investigation, A.T. and M.S.B.; Methodology, A.T. and M.S.B.; Project administration, A.T. and M.S.B.; Supervision, A.T.; Validation, A.T. and M.S.B.; Writing – original draft, A.T.; Writing – review & editing, A.T. and M.S.B. All authors have read and agreed to the published version of the manuscript.
This study was not supported by any sponsor or funder.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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