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Efficacy and Safety of SGLT2 Inhibitors in Pediatric Patients and Young Adults: A Systematic Review and Meta-Analysis

Rafael Dos Santos Borges1, Ana Flávia Conegundes1, Luiza Haikal de Paula1

  • 1Faculty of Medicine, Universidade Federal de Minas Gerais, Avenue Prof. Alfredo Balena, 190-Santa Efigênia, Belo Horizonte-MG, Belo Horizonte 30130-100, Minas Gerais, Brazil.

Pediatric Diabetes
|April 30, 2025
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) significantly improve glycemic control in pediatric patients and young adults with type 2 diabetes mellitus (T2DM). This meta-analysis found SGLT2i to be effective and safe, with no significant increase in adverse events compared to placebo.

Area of Science:

  • Endocrinology and Metabolism
  • Pediatric Diabetes Research
  • Pharmacological Interventions

Background:

  • Rising incidence of type 2 diabetes mellitus (T2DM) in pediatric populations.
  • Unique challenges in managing pediatric T2DM, including glycemic control durability and early complications.
  • Limited approved treatment options and comprehensive studies for T2DM in youth.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in pediatric patients and young adults with T2DM.
  • To compare SGLT2i treatment against placebo in this specific age group.
  • To synthesize current evidence from randomized controlled trials on SGLT2i in youth-onset T2DM.

Main Methods:

  • Systematic literature search of PubMed, Embase, Cochrane, and Web of Science for relevant randomized controlled trials.
  • Inclusion criteria focused on patients aged 10–24 years with T2DM, comparing SGLT2i to placebo.
  • Statistical analysis performed using RevMan 5.4 and R statistical software, with heterogeneity assessed using I statistics.

Main Results:

  • Three studies with 334 patients demonstrated a significant reduction in HbA1c levels with SGLT2i compared to placebo (MD = -0.93; p < 0.0001).
  • Fewer patients in the SGLT2i group required rescue medication or discontinued treatment due to lack of efficacy (RR = 0.64; p = 0.02).
  • No statistically significant differences were observed in the incidence of any adverse events, serious side effects, or individual adverse effects between SGLT2i and placebo groups.

Conclusions:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective in improving glycemic control in children, adolescents, and young adults with type 2 diabetes mellitus.
  • SGLT2i demonstrated a favorable safety profile in this population, comparable to placebo regarding adverse events.
  • These findings support the potential role of SGLT2i as a therapeutic option for managing T2DM in younger individuals.

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