PotassiumNEW2026-09

Impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with heart failure with reduced ejection fraction without diabetes.

Abd El Hady Yasser Ahmed, Abd Elaziz Abd Allah Shahat Ali, Adly Mahmoud Abeer — Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology

Summary

This study investigated a type of medication called SGLT2 inhibitors, usually prescribed for diabetes, in patients with heart failure who do not have diabetes. Researchers found that these drugs safely lowered blood sugar levels and also improved heart function in this specific group. This suggests SGLT2 inhibitors could offer benefits beyond diabetes treatment for certain heart failure patients.

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Key points

SGLT2 inhibitors, a class of drugs for diabetes, were tested in heart failure patients who do not have diabetes.
The study found these medications safely reduced blood sugar levels in this non-diabetic heart failure group.
Treatment with SGLT2 inhibitors also led to improvements in heart function.
The drugs showed potential benefits for heart failure patients without diabetes, with minimal side effects like low blood sugar.

What the study looked at

**What question the study asked:** This research aimed to understand if a type of medication called SGLT2 inhibitors, commonly used to manage type 2 diabetes, could also affect blood sugar levels in patients who have a specific type of heart failure (with reduced ejection fraction) but do not have diabetes. **How it was studied:** Researchers conducted a randomized controlled trial involving 130 non-diabetic patients with heart failure. Participants were monitored over three months, with one group receiving SGLT2 inhibitors and another receiving standard care. Various health markers, including blood sugar and heart function, were measured at the beginning and end of the study period. **What it found:** The study revealed that SGLT2 inhibitors significantly lowered blood glucose levels in these non-diabetic heart failure patients without causing dangerous drops in blood sugar. Furthermore, the medication improved several indicators of heart function, such as the heart's pumping ability. The treatment was generally well-tolerated, with few adverse effects reported.

Dietary takeaway

While this study monitored potassium levels, it did not report any significant changes in potassium due to SGLT2 inhibitor treatment. For individuals with heart failure, maintaining a balanced diet rich in potassium from foods like fruits, vegetables, and legumes is generally important for overall heart health, but it's crucial to discuss any dietary changes or concerns about electrolyte balance with your doctor, especially when on medication. Remember, this is just one study, and more research is needed to confirm these findings and fully understand the long-term effects.

Abstract

INTRODUCTION AND OBJECTIVES: Sodium-glucose cotransporter 2 inhibitors (SGLT2) were initially developed as antihyperglycemic agents for the management of type 2 diabetes mellitus (T2DM). This study sought to evaluate the impact of sodium-glucose cotransporter 2 inhibitors on blood glucose levels in patients with HFrEF without diabetes. METHODS: This randomized controlled trial included 130 patients with HF classified as NYHA class II to IV and without diabetes, with an ejection fraction (EF) below 40% as determined by echocardiography within the preceding three months. Baseline assessments included serum creatinine, random and fasting blood glucose, 2-hour postprandial glucose, HbA1c, urine acetone, BMI, blood pressure, and serum electrolytes (sodium, potassium, magnesium, ionized calcium, and phosphorus). After three months of treatment, all these clinical and laboratory parameters were reassessed in both groups. RESULTS: Treatment led to significant improvements in cardiac function, including reductions in left ventricular diameters and volumes, and increases in ejection fraction, tricuspid annular plane systolic excursion, and right ventricular fractional area change (p<0.05). Glycemic control also improved, with significant decreases in fasting, postprandial, HbA1c, and random blood glucose (p<0.001). Serum creatinine, magnesium, and phosphorus levels increased significantly (p<0.001). Adverse events were minimal, with only one patient showing urine acetone positivity (1.5%, p=0.99), and no symptomatic hypoglycemia, ketoacidosis, or significant hypotension occurred. CONCLUSIONS: SGLT2 inhibitors safely reduce blood glucose in patients with HFrEF without diabetes without causing hypoglycemia, highlighting their potential cardiovascular and metabolic benefits and supporting their use in this population.

View on PubMed →DOI: 10.1016/j.repc.2026.04.007