Abstract 13769: Prognostic Impact of Sodium-Glucose Co-Transporter-2 Inhibitors Therapy on All-Cause Mortality Among Patients With Diabetes Mellitus and Cancer

Abstract

Introduction: Diabetes mellitus (DM) and cancer are prevalent diseases associated with the process of aging and exhibit a high likelihood of co-occurrence. Extensive evidence supports the notion that DM serves as a risk factor for various forms of cancer, and it is strongly associated with an unfavorable prognosis. The correlation is believed to be influenced by multiple pathways, including hyperinsulinemia, hyperglycemia, and inflammation. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all-cause mortality and cardiovascular outcomes. Hypothesis: The aim of our study was to assess the correlation between SGLT2i therapy and all-cause mortality, among patients diagnosed with DM and cancer Methods: We conducted a retrospective, single-center, observational study including all patients diagnosed with DM and cancer between January 2016 to January 2023. Patients were divided into two groups: patients treated with SGLT2i prior to cancer diagnosis (SGLT2i) and patients SGLT2i naive (non-SGLT2i). The primary endpoint was all-cause mortality. Results: Overall, 7085 patients were included in our cohort; 985 patients in the SGLT2i group and 6100 patients in the non-SGLT2i group. At a median follow-up of 42 months [IQR 23, 60] we observed a significantly lower all-cause mortality among the SGLT2i group (23% vs. 38%, p<0.001). Using a multivariable Cox regression analysis, SGLT2i therapy emerged as an independent significant predictor for reduced all-cause mortality (Hazard Ratio (HR) 0.637 [95% confidence interval (CI) 0.555-0.731], p<0.001). Conclusions: SGLT2i therapy was found to be effective, associated with a significantly reduced all-cause mortality in patients diagnosed with DM and cancer. Randomized clinical trials are needed to establish the role of SGLT2i specifically in cancer patients and better understand its mechanism.