OBJECTIVES: SGLT2is are hypoglycaemic drugs that are also associated with reduction in intravascular blood pressure along with increasing the circulating ketone bodies, thus protecting heart and kidneys. They have also been reported to greatly improve patients' HRQoL. This SLR aimed to evaluate the impact of SGLT2is on HRQoL in patients with T2DM.

METHODS: Electronic searches on EMBASE and Medline were performed to capture HRQoL evidence in patients receiving SGLT2is published between 2012–2022. The protocol was registered on PROSPERO (ID: CRD42022323618).

RESULTS: A total of 46 citations qualified for inclusion in the SLR. Eight of nine publications reported improvements in EQ-5D scores with SGLT2is±metformin/saxagliptin, with EQ-5D VAS scores increasing from 67.3–74.6 at baseline to 75.3–78.2 at week 24 (p=0.0001). A real-world study comparing sequential order of treatment with three drug classes, i.e., SGLT2i added to GLP1ra, GLP-1ra added to SGLT2i, and GLP-1ra+SGLT2i showed significant improvements in EQ-5D scores from baseline, with mean differences of 5.1, 8.9, and 3.8 points, respectively (p<0.0001). Studies using other generic tools (e.g., SF-12/36) also reported improvements in HRQoL with different SLGT2is (4 studies) and with combination therapy over SLGT2i monotherapy (2 studies).

Nine studies using tools assessing the impact of weight loss on HRQoL (WRQoL or IWQoL) showed that SGLT2is therapy was associated with reduction in body weight concomitant to good glycaemic control that leads to increased self-management and meaningful improvements in HRQoL. Disease specific HRQoL questionnaires, Diabetes Treatment Satisfaction Questionnaire [DTSQ] (4 studies), diabetes therapy-related QoL [DTR-QoL] (6 studies) and Current Health Satisfaction Questionnaire [CHES-Q] scores (9 studies) also provided evidence for a positive impact of SGLT2is on HRQoL in patients with T2DM.

CONCLUSIONS: Multiple tools assessing HRQoL in patients with T2DM provide evidence for improvements in HRQoL for patients with T2DM receiving SGLT2is alone or in combination other hypoglycaemic drugs.