Efficacy of SGLT2 Inhibitors in Reducing Hospitalization for Heart Failure in Patients with Type 2 Diabetes: A Meta-Analysis

Abstract

Background: Type 2 diabetes mellitus (T2D) is a consequence of heart failure (HF), a significant issue in the health care environment, as a disease and death cause and an initiator of health care utilization. Hospitalization cost of heart failure (HHF) is an outcome measure for evaluating the effectiveness of treatment. Methodology: The current study aims to perform a balanced evaluation of the efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on the prevention of HHF among T2D patients through aggregating qualitative numbers of randomized controlled trials (RCTs), observational studies, and clinical approaches. From 2015 to 2025, secondary qualitative meta-analysis was conducted based on evidence from PubMed, Scopus, and Google Scholar. Peer-reviewed randomized controlled trials, cohort studies, and periodical reports were included with the additional effect of SGLT2i on heart failure hospitalization (HHF). Findings: Primary extracting themes were medical efficacy, mechanistic explanation, heterogeneity of subdivisions, and the impact of implementation. The CASP agenda was used to test for bias. Thematic synthesis of the controversial trials reaffirms that SGLT2 inhibitors (SGLT2i) reduce hospitalization for heart failure (HHF) in T2D patients. This has been observed in trials such as EMPA-REG, CANVAS, and DECLARE-TIMI 58. The benefits spread beyond those associated with reduced blood glucose levels and comprise proposed mechanisms such as natriuresis, enhanced renal hemodynamics, and positive cardiac remodelling. Benefits across diverse subpopulations of patients, together with those with or without preceding heart failure and those with chronic kidney disease (CKD), were also found. Conclusions: Thus, there is substantial indication that has influenced clinical practice, leading the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) to recommend that SGLT2i be measured as an early agent for patients at high risk. Additional studies are compulsory to determine patient-centred viewpoints and provincial inequalities in medical implementation.