sodium-glucose cotransporter 2 inhibitor & blood count

Q; SGLT2 (sodium-glucose cotransporter-2) inhibitors are getting immensely popular for diabetes management. They tend to cause? - select one

A) Anemia

B) Polycythemia

Answer: B

SGLT2 inhibitors are becoming popular not only for diabetic management but also for patients with congestive heart failure and chronic renal disease. 

SGLT2 inhibitors cause еrуthrοϲуtоsis due to increased serum erythropoietin (EPO) production via hypoxia-induced activation of HIF2a, modulation of iron metabolism through hepcidin, and/or hemoconcentration.

Fortunately, with discontinuation of drugs, it is reversible.

#hematology

#pharmacology

References:

1. Gangat N, Szuber N, Alkhateeb H, et al. JAK2 wild-type erythrocytosis associated with sodium-glucose cotransporter 2 inhibitor therapy. Blood 2021; 138:2886.

2. Mazer CD, Hare GMT, Connelly PW, et al. Effect of Empagliflozin on Erythropoietin Levels, Iron Stores, and Red Blood Cell Morphology in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease. Circulation 2020; 141:704.

3. Ghanim H, Abuaysheh S, Hejna J, et al. Dapagliflozin Suppresses Hepcidin And Increases Erythropoiesis. J Clin Endocrinol Metab 2020; 105.