Last updated August 21, 2026
Key finding
Canagliflozin significantly reduced the primary outcome of ECV (adjusted mean difference [AMD]: −3.67%; 95% CI −5.33, −2.01; p <0.001)
This study evaluated the effects of Canagliflozin on myocardial fibrosis in high-risk type 2 diabetes patients, finding significant reductions in extracellular volume and left ventricular metrics.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
High Risk
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the effects of Canagliflozin on myocardial fibrosis in high-risk type 2 diabetes patients, finding significant reductions in extracellular volume and left ventricular metrics.
The findings suggest that Canagliflozin may offer cardiovascular benefits beyond glucose control for patients with high-risk type 2 diabetes. Reducing myocardial fibrosis could lead to better heart health outcomes, potentially lowering the risk of heart failure and other cardiovascular complications in this population.
The study's sample size and specific population may limit generalizability. Effectiveness of Canagliflozin on long-term outcomes remains unclear. No significant change in HbA1c levels between groups.
Published in
Publication details and source links for this paper.
Hongmei Y, Jiaojiao L, Zhitian Z, et al. Canagliflozin Reduces Myocardial Fibrosis in High-Risk Type 2 Diabetes. Diabetologia. 2026;69(6). doi:10.1007/s00125-026-06682-w
Canagliflozin reduced extracellular volume change by −3.67% (p <0.001).
Left ventricular end-diastolic volume decreased by −20.72 ml (p =0.010).
Echocardiography-derived end-diastolic diameter was reduced by −2.82 mm (p =0.010).
Evidence network
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This study contributes evidence to Canagliflozin and Catecholamine Levels in Normo- and Hyperglycemia, Extracellular volume, HbA1c, and 1 more.
This study contributes evidence to
Primary intervention
Canagliflozin
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
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2
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4
Evidence pairs
452
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Contributes evidence
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Contributes evidence
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Primary evidence
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Core evidence
The primary outcomes reported in this study.
Canagliflozin → Catecholamine Levels in Normo- and Hyperglycemia
Canagliflozin → Catecholamine Levels in Normo- and Hyperglycemia
Canagliflozin → Left ventricular end-diastolic volume
Canagliflozin → Left ventricular end-diastolic volume
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on SGLT2 Inhibitors and HbA1c, SGLT2 Inhibitors and Catecholamine Levels in Normo- and Hyperglycemia.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on SGLT2 Inhibitors
Contributes to SGLT2 Inhibitors evidence base.
All studies measuring Catecholamine Levels in Normo- and Hyperglycemia
Measures Catecholamine Levels in Normo- and Hyperglycemia as a key outcome.
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Published within the last 2 years.
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3 results
1 results
3 results
3 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
SGLT2 Inhibitors may improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 79.0 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is based on 19 supporting studies with consistent results and a positive effect signal.
Limitations
SGLT2 Inhibitors appears to improve Left Ventricular Structure.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Left ventricular end-diastolic volume
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Canagliflozin appears to improve Catecholamine Levels in Normo- and Hyperglycemia.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Catecholamine Levels in Normo- and Hyperglycemia
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Canagliflozin appears to improve Extracellular volume.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Extracellular volume
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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