Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundDiabetes and cancer exhibit a high likelihood of co‐occurrence. Diabetes serves as a risk factor for various forms of cancer and is associated with a poorer prognosis. SGLT2 (sodium‐glucose cotransporter 2) inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all‐cause mortality in the general population; however, data among the population with cancer are scarce. We aimed to assess the safety and efficacy of SGLT2i therapy among patients with diabetes and cancer.MethodsA large retrospective, single‐center study including 849 patients diagnosed with diabetes and active cancer. Patients were divided into 2 groups: 169 patients treated with SGLT2i before cancer diagnosis and 680 patients SGLT2i naive. The primary end point was all‐cause mortality. The secondary end point was the composite of cardiovascular outcomes, including heart failure, acute coronary syndrome, and arrhythmias.ResultsAfter a median follow‐up of 48 months (interquartile range, 27–72), all‐cause mortality was significantly lower in the SGLT2i group (67% versus 53%,P=0.001).
Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundDiabetes and cancer exhibit a high likelihood of co‐occurrence. Diabetes serves as a risk factor for various forms of cancer and is associated with a poorer prognosis. SGLT2 (sodium‐glucose cotransporter 2) inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all‐cause mortality in the general population; however, data among the population with cancer are scarce. We aimed to assess the safety and efficacy of SGLT2i therapy among patients with diabetes and cancer.MethodsA large retrospective, single‐center study including 849 patients diagnosed with diabetes and active cancer. Patients were divided into 2 groups: 169 patients treated with SGLT2i before cancer diagnosis and 680 patients SGLT2i naive. The primary end point was all‐cause mortality. The secondary end point was the composite of cardiovascular outcomes, including heart failure, acute coronary syndrome, and arrhythmias.ResultsAfter a median follow‐up of 48 months (interquartile range, 27–72), all‐cause mortality was significantly lower in the SGLT2i group (67% versus 53%,P=0.001). Multivariable Cox regression identified SGLT2i as an independent predictor of reduced all‐cause mortality (hazard ratio, 0.676 [95% CI, 0.532–0.860],P=0.001). Cardiovascular outcomes were higher in the SGLT2i group (28% versus 16%,P=0.001), driven by increased heart failure events (14% versus 7%,P=0.008). After propensity score matching, SGLT2i remained a significant predictor of reduced mortality (P=0.016), with no significant differences in cardiovascular outcome (P=0.067).ConclusionsSGLT2i was associated with lower all‐cause mortality in patients diagnosed with diabetes and cancer. Randomized clinical trials are needed to confirm these findings and explore the underlying mechanism.