StrongDecrease
All-cause mortality
SGLT2 inhibitors → All-cause mortality
SGLT2 inhibitors → All-cause mortality
Evidence profile
StrongDecreaseClinical Outcomes
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Research Summary
Analyzed using Evidence Intelligence™
SGLT2 inhibitors reduce cardiovascular events in diabetes
Key finding
The risk of MACE was 11.5% for SGLT2i users versus 14.2% for DPP4i users (risk-difference: 2.8 percentage-points, 95% CI: 1.1–4.4%).
This study compared the real-world effectiveness of SGLT2 inhibitors and DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease, finding that SGLT2 inhibitors were associated with lower risks of major adverse cardiovascular events.
Evidence strength
Moderate confidence
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Some Concerns bias
Last updated July 6, 2026Quick read
Study at a glance
The essential study design details in one scan.
Population
Young Adult (19–39), Middle Aged (40-64), Male, Female, Asia-Pacific (APAC), with T2 Diabetes
Intervention
SGLT2 inhibitors
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Primary outcome
Major adverse MACE
Comparator
DPP4i group
Plain-language summary
What this paper says
A plain-language read of the study's main message and where it applies.
Study focus
This study compared the real-world effectiveness of SGLT2 inhibitors and DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease, finding that SGLT2 inhibitors were associated with lower risks of major adverse cardiovascular events.
Clinical relevance
The findings highlight the potential advantages of SGLT2 inhibitors over DPP4 inhibitors in managing patients with type 2 diabetes and cardiovascular disease. By demonstrating lower risks of serious outcomes, these results can inform treatment decisions and improve patient care, ultimately leading to better health outcomes in this vulnerable population.
Keep in mind
The study design was non-randomized, which may introduce bias. Results may not be generalizable to all populations with type 2 diabetes. Unmeasured confounders could affect the outcomes.
Published in
Journal Reference
Publication details and source links for this paper.
Puriya DWY, Kathrine KS, Bochra Z, et al. Real-world effectiveness of SGLT2 inhibitors versus DPP4 inhibitors in patients with type 2 diabetes and cardiovascular disease. Cardiovascular Diabetology. 2025;24:371. doi:10.1186/s12933-025-02924-0
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Main Effects
SGLT2 inhibitors reduced the risk of major adverse cardiovascular events by 2.8 percentage-points.
Heart failure hospitalizations were lower by 5.1 percentage-points in SGLT2 inhibitor users.
All-cause mortality was reduced by 3.1 percentage-points with SGLT2 inhibitors.
Stroke incidence showed a risk reduction of 2.4 percentage-points with SGLT2 inhibitors.
Evidence network
How this study fits
Understand where this research contributes within the broader evidence network.
Evidence Context
This study contributes evidence to SGLT2 inhibitors and All-cause mortality, Composite cardiovascular events (CV death, MI, stroke, HF hospitalization), Heart failure hospitalizations, and 1 more.
This study contributes evidence to
Primary intervention
SGLT2 inhibitors
Primary outcomes
- All-cause mortality
- Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
- Heart failure hospitalizations
Evidence topics
Primary intervention
Evidence relationships
Intervention and outcome relationships this study adds to the evidence network.
4
Evidence pairs
4
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.
Moderate contributionModerate confidenceNetwork score: 72
3
Related topics
4
Evidence pairs
178
Related studies
High relevance in at least one topic
Why it is useful
- Contributes to 4 evidence relationships
- Includes primary outcome data
- Linked to 3 direct semantic evidence topics
Topic contributions
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Core evidence
Study findings
The primary outcomes reported in this study.
StrongDecrease
Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
SGLT2 inhibitors → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
SGLT2 inhibitors → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Evidence profile
StrongDecreaseClinical Outcomes
Unlock full evidence details
StrongDecrease
Heart failure hospitalizations
SGLT2 inhibitors → Heart failure hospitalizations
SGLT2 inhibitors → Heart failure hospitalizations
Evidence profile
StrongDecreaseClinical Outcomes
Unlock full evidence details
StrongDecrease
Incidence of stroke
SGLT2 inhibitors → Incidence of stroke
SGLT2 inhibitors → Incidence of stroke
Evidence profile
StrongDecreaseClinical Outcomes
Unlock full evidence details
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Evidence Suggest
- SGLT2 inhibitors associated with a 2.8 percentage-point lower risk of major adverse cardiovascular events.
- 5.1 percentage-point reduction in heart failure hospitalizations with SGLT2 inhibitors.
- 3.1 percentage-point decrease in all-cause mortality for SGLT2 inhibitor users.
Who this applies to
- Adults with type 2 diabetes and cardiovascular disease.
- Patients currently prescribed either SGLT2 or DPP4 inhibitors.
Keep in Mind
- The study's non-randomized design limits causal inferences.
- Findings may not apply to younger populations or those without cardiovascular disease.
- Further research is needed to confirm these results in diverse settings.
Between the Lines
- The study design was non-randomized, which may introduce bias.
- Results may not be generalizable to all populations with type 2 diabetes.
- Unmeasured confounders could affect the outcomes.
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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 SGLT2 Inhibitors and Cardiovascular Outcomes, SGLT2 Inhibitors and Incidence of stroke.
Related evidence relationships
Explore in Evidence ArchiveThis study contributes to the evidence on the following intervention-outcome relationships.
Included in these evidence collections
Curated evidence collections and hubs this study is part of.
Cardiovascular Outcomes Evidence Hub
All studies measuring Cardiovascular Outcomes
1 studies
outcome_hubMeasures Cardiovascular Outcomes as a key outcome.
Incidence of stroke Evidence Hub
All studies measuring Incidence of stroke
1 studies
outcome_hubMeasures Incidence of stroke as a key outcome.
SGLT2 Inhibitors Evidence Hub
All studies on SGLT2 Inhibitors
1 studies
intervention_hubContributes to SGLT2 Inhibitors evidence base.
Recent Diabetes Research
Latest published studies
recency_collection
Published within the last 2 years.
Explore more in the evidence archive
Jump to pre-filtered views in the evidence archive.
All studies on SGLT2 inhibitors and Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Intervention: SGLT2 inhibitorsOutcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
1 results
All studies on SGLT2 inhibitors and Incidence of stroke
Intervention: SGLT2 inhibitorsOutcome: Incidence of stroke
1 results
All studies on SGLT2 inhibitors
Intervention: SGLT2 inhibitors
1 results
All studies measuring Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Outcome: Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
1 results
All studies measuring Incidence of stroke
Outcome: Incidence of stroke
1 results
Questions answered by this study
Generated from the study's connected evidence using Evidence Intelligence™.
Does SGLT2 Inhibitors improve cardiovascular outcomes?
Emerging Evidence
SGLT2 Inhibitors appears to improve Cardiovascular Outcomes.
ConsensusScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
EvidenceScore™ Emerging | EvidenceScore™ 55.5 | strong positive | ConsensusScore™ Unclear | 1 study
- 2
All-cause mortality
EvidenceScore™ Emerging | EvidenceScore™ 51.0 | moderate positive | ConsensusScore™ Mixed | 1 study
Why this answer: This answer is based on 5 supporting studies and existing graph evidence signals.
Limitations
- Consistency cannot yet be determined.
- Population details are unavailable.
Does SGLT2 inhibitors improve incidence of stroke?
Emerging Evidence
SGLT2 inhibitors appears to improve Incidence of stroke.
ConsensusScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
- 1
Incidence of stroke
EvidenceScore™ Emerging | EvidenceScore™ 55.5 | strong positive | ConsensusScore™ 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.
Does SGLT2 inhibitors improve heart failure hospitalizations?
Emerging Evidence
SGLT2 inhibitors may improve Heart failure hospitalizations.
ConsensusScore™: Results are mixed and should be interpreted cautiously.
Evidence caveat: The available evidence reports mixed findings.
Ranked evidence signals
- 1
Heart failure hospitalizations
EvidenceScore™ Emerging | EvidenceScore™ 51.0 | moderate positive | ConsensusScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
- Only one supporting study is available.
- Population details are unavailable.
Next steps
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