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Antidiabetic Medications and Bladder Cancer Risk in Type 2 Diabetes: A Systematic Review and Meta-Analysis of

Yufeng Rao1, Shiqiu Meng2, Evan Yi-Wen Yu3

  • 1Department of Epidemiology, Maastricht University, Maastricht, the Netherlands; Institute of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|December 19, 2025
PubMed
Abstract

Insights

This study found no significant link between common antidiabetic medications and bladder cancer (BC) risk in type 2 diabetes mellitus (T2DM) patients. The findings support the long-term safety of these essential T2DM treatments.

Area of Science:

  • Endocrinology and Metabolism
  • Oncology
  • Pharmacology

Background:

  • Long-term safety of antidiabetic medications is crucial for managing type 2 diabetes mellitus (T2DM).
  • Potential associations between antidiabetic drugs and bladder cancer (BC) risk require thorough investigation.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs) assessing the association between antidiabetic medications and bladder cancer (BC) risk.
  • To evaluate the safety profile of various antidiabetic drug classes in T2DM patients concerning BC incidence.

Main Methods:

  • Systematic review and meta-analysis of RCTs comparing antidiabetic medications to placebo in T2DM patients.
  • Searched major databases (PubMed, Embase, Web of Science, Cochrane) up to June 2025.
  • Utilized random-effects model for pooled odds ratio (OR) and 95% confidence interval (CI); assessed heterogeneity with I² statistic and publication bias via funnel plots.

Main Results:

  • Overall, antidiabetic medications showed no significant association with increased or decreased BC risk (OR = 0.90, 95% CI: 0.67-1.20).
  • Subgroup analyses for DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors also revealed no statistically significant BC risk.
  • Thiazolidinediones showed a non-significant increased OR (2.37) in one study; no significant publication bias detected.

Conclusions:

  • Current evidence suggests that commonly used antidiabetic medications, including DPP-4i, GLP-1Ras, and SGLT-2i, do not significantly increase bladder cancer risk in T2DM patients.
  • These findings reinforce the established long-term safety of these antidiabetic drug classes for T2DM management.
Keywords:
antidiabetic medicationsbladder cancermeta-analysisrandomized controlled trialstype 2 diabetes mellitus

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