Abstract
AIM: To assess the association between sodium-glucose cotransporter 2 (SGLT2) inhibitor use and the risk of tumor development and survival outcomes in patients with type 2 diabetes. METHODS: This retrospective cohort study included 350 patients with type 2 diabetes treated at our institution between January 2021 and January 2025. Patients were categorized into an observation group (n = 189) receiving SGLT2 inhibitors and a control group (n = 161) treated with other antidiabetic medications. Clinical characteristics, glycemic control, cumulative drug exposure, and tumor incidence (lung, colorectal, prostate, breast, bladder, and hepatic cancers) were analyzed. Kaplan-Meier methods were used to evaluate cancer incidence and mortality outcomes. RESULTS: Overall tumor incidence was significantly lower in the SGLT2 inhibitor group than in the control group (P < 0.001), mainly due to reduced lung (P = 0.018) and ovarian cancers (P = 0.017). Smoking, alcohol consumption, and poor glycemic control were associated with higher overall and site-specific tumor risks. The SGLT2 inhibitor group showed better metabolic profiles, with lower FBG, HbA1c, LDL, TC, TG, and higher HDL levels (all P < 0.05), as well as improved renal function indicated by lower BUN and creatinine and higher eGFR (all P < 0.001). Kaplan-Meier analysis demonstrated significantly longer progression-free and overall survival in the SGLT2 inhibitor group (both P < 0.01). CONCLUSION: SGLT2 inhibitors reduced overall tumor risk, especially lung and ovarian cancers, and improved metabolic and survival outcomes in type 2 diabetes.