Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerPharmacological TreatmentsType 2 Diabetes (T2D)
Research Summary
Analyzed using Evidence Intelligence™
Canagliflozin may reduce myocardial fibrosis in high-risk type 2 diabetes
Last updated June 2, 2026
Key finding
In a 26-week randomized trial, canagliflozin reduced CMR-measured myocardial extracellular volume and improved some left ventricular structural measures versus sitagliptin in adults with type 2 diabetes at high cardiovascular risk.
This trial compared canagliflozin with sitagliptin in adults with type 2 diabetes and high cardiovascular risk. Over 26 weeks, canagliflozin lowered a cardiac MRI marker linked to myocardial fibrosis and improved some measures of heart structure, while blood sugar lowering was similar in both groups.
Quick read
Study at a glance
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
Randomized Controlled Trials (RCTs)
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
In a 26-week randomized trial, canagliflozin reduced CMR-measured myocardial extracellular volume and improved some left ventricular structural measures versus sitagliptin in adults with type 2 diabetes at high cardiovascular risk.
Published in
Journal Reference
Publication details and source links for this paper.
Yan H, Liu J, Zhang Z, et al. Canagliflozin attenuates CMR-quantified myocardial fibrosis in individuals with type 2 diabetes mellitus at high cardiovascular risk: a randomised open-label controlled trial. Diabetologia. 2026;69(6):1532-1544. doi:10.1007/s00125-026-06682-w
Main Effects
Canagliflozin ↓ myocardial extracellular volume versus sitagliptin at 26 weeks
Canagliflozin ↓ left ventricular end-diastolic volume and diameter
HbA1c ↓ similarly in both groups, with no clear between-group difference
Evidence network
How this study fits
Understand where this research contributes within the broader evidence network.
Evidence Context
This study contributes evidence to Canagliflozin, Sitagliptin and Extracellular volume, HbA1c, Left ventricular ejection fraction (LVEF), and 3 more.
This study contributes evidence to
Primary intervention
Canagliflozin
Primary outcomes
- Extracellular volume
- HbA1c
- Left ventricular ejection fraction (LVEF)
Evidence topics
Primary intervention
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
7
Evidence pairs
7
Relationships
3
Evidence topics
contributes_evidence
Editorial context
Why this study matters
See why this paper is useful beyond its individual results.
Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
High contributionHigh confidenceNetwork score: 80
3
Related topics
7
Evidence pairs
262
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 7 evidence relationships
- Includes primary outcome data
- Uses a randomized study design signal
- Linked to 3 direct semantic evidence topics
Topic contributions
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
DPP-4 Inhibitors and HbA1c
Related evidence
Evidence relationship
SGLT2 Inhibitors and HbA1c
Save evidence
Evidence relationship
SGLT2 Inhibitors and Urinary Tract Infections
Save evidence
Core evidence
Study findings
The primary outcomes reported in this study.
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerLeft ventricular ejection fraction (LVEF)
Canagliflozin → Left ventricular ejection fraction (LVEF)
Canagliflozin → Left ventricular ejection fraction (LVEF)
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerLeft ventricular end-diastolic diameter
Canagliflozin → Left ventricular end-diastolic diameter
Canagliflozin → Left ventricular end-diastolic diameter
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerLeft ventricular end-diastolic volume
Canagliflozin → Left ventricular end-diastolic volume
Canagliflozin → Left ventricular end-diastolic volume
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerUrinary tract infection rate
Canagliflozin → Urinary tract infection rate
Canagliflozin → Urinary tract infection rate
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 55
- Slightly Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence TrackerEvidence Intelligence™
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ImpactScore™
- 89
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 4 studies
Add to Evidence TrackerEvidence Library
Build your evidence library
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Evidence Suggest
- Primary cardiac MRI fibrosis marker favored canagliflozin over active comparator
- Some structural remodeling measures improved, but systolic function measures did not clearly differ
- Cardiac effects appeared separate from glucose lowering because HbA1c reductions were similar in both groups
Who this applies to
Adults aged 18 to 75 years with type 2 diabetes
Keep in Mind
This was a 26-week study, so long-term durability is unknown
Between the Lines
- Small single-center trial with 45 randomized participants
- Open-label design may introduce bias despite blinded outcome assessment
- Main findings rely on surrogate imaging markers rather than clinical cardiovascular events
Evidence Library
Build your evidence library
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Connected Evidence
Explore related studies, evidence collections, and research questions.
Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on DPP-4 Inhibitors and HbA1c, SGLT2 Inhibitors and Extracellular volume.
Related evidence relationships
Explore in Evidence ExplorerThis study contributes to the evidence on the following intervention-outcome relationships.
Medications
DPP-4 Inhibitors → HbA1c
Medications
Evidence Intelligence™
- EvidenceScore™
- Strong
- Score 79 · Based on 4 studies
- ImpactScore™
- 89
- Very Positive
- ConsistencyScore™
- 100
- consistent
Supporting studies: Based on 4 studies
View evidenceMedications
SGLT2 Inhibitors → Extracellular volume
Medications
Evidence Intelligence™
- EvidenceScore™
- Emerging
- Score 59 · Based on 1 study
- ImpactScore™
- 100
- Very Positive
- ConsistencyScore™
- unclear
- Not enough independent studies
Supporting studies: Based on 1 study
View evidenceIncluded in these evidence collections
Curated evidence collections and hubs this study is part of.
DPP-4 Inhibitors Evidence Hub
All studies on DPP-4 Inhibitors
4 studies
intervention_hubContributes to DPP-4 Inhibitors evidence base.
HbA1c Evidence Hub
All studies measuring HbA1c
4 studies
outcome_hubMeasures HbA1c as a key outcome.
Extracellular volume Evidence Hub
All studies measuring Extracellular volume
1 studies
outcome_hubMeasures Extracellular volume as a key outcome.
SGLT2 Inhibitors Evidence Hub
All studies on SGLT2 Inhibitors
1 studies
intervention_hubContributes to SGLT2 Inhibitors evidence base.
Explore more in Evidence Explorer
Jump to pre-filtered views in Evidence Explorer.
All studies on Sitagliptin and HbA1c
Intervention: SitagliptinOutcome: HbA1c
4 results
All studies on Canagliflozin and Extracellular volume
Intervention: CanagliflozinOutcome: Extracellular volume
1 results
All studies on Sitagliptin
Intervention: Sitagliptin
4 results
All studies on Canagliflozin
Intervention: Canagliflozin
1 results
All studies measuring HbA1c
Outcome: HbA1c
4 results
Questions answered by this study
Generated from the study's connected evidence using Evidence Intelligence™.
Does DPP-4 Inhibitors improve HbA1c?
Strong Evidence
DPP-4 Inhibitors appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 79.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 8 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does SGLT2 Inhibitors improve HbA1c?
Strong Evidence
SGLT2 Inhibitors may improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
- 1
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 12 supporting studies with consistent results and a positive effect signal.
Limitations
- Population details are unavailable.
Does SGLT2 Inhibitors improve urinary tract infections?
Strong Evidence
SGLT2 Inhibitors may improve Urinary Tract Infections.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Evidence caveat: The available evidence reports mixed findings.
Ranked evidence signals
- 1
Urinary tract infection rate
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
- Population details are unavailable.
Does SGLT2 Inhibitors improve left ventricular structure?
Emerging Evidence
SGLT2 Inhibitors may improve Left Ventricular Structure.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Left ventricular ejection fraction (LVEF)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
- 2
Left ventricular end-diastolic diameter
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
- 3
Left ventricular end-diastolic volume
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
- Only one supporting study is available.
- Consistency cannot yet be determined.
- Population details are unavailable.
Next steps
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