{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:15:06Z","timestamp":1773850506884,"version":"3.50.1"},"reference-count":76,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Shenzhen Key Medical Discipline","award":["SZXK2020081"],"award-info":[{"award-number":["SZXK2020081"]}]},{"name":"the Sanming Project of HKU-SZH Cardiology","award":["SZSM201911020"],"award-info":[{"award-number":["SZSM201911020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Individuals with type 2 diabetes mellitus (DM) have an increased risk of pneumonia and septic shock. Traditional glucose-lowering drugs have recently been found to be associated with a higher risk of infections. It remains unclear whether sodium-glucose cotransporter 2 inhibitors (SGLT2is), which have pleiotropic\/anti-inflammatory effects, may reduce the risk of pneumonia and septic shock in DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, Embase, and ClinicalTrials.gov were searched from inception up to May 19, 2022, for randomized, placebo-controlled trials of SGLT2i that included patients with DM and reported outcomes of interest (pneumonia and\/or septic shock). Study selection, data extraction, and quality assessment (using the Cochrane Risk of Bias Assessment Tool) were conducted by independent authors. A fixed-effects model was used to pool the relative risk (RRs) and 95% CI across trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 4568 citations, 26 trials with a total of 59 264 patients (1.9% developed pneumonia and 0.2% developed septic shock) were included. Compared with placebo, SGLT2is significantly reduced the risk of pneumonia (pooled RR 0.87, 95% CI 0.78-0.98) and septic shock (pooled RR 0.65, 95% CI 0.44-0.95). There was no significant heterogeneity of effect size among trials. Subgroup analyses according to the type of SGLT2i used, baseline comorbidities, glycemic control, duration of DM, and trial follow-up showed consistent results without evidence of significant treatment-by-subgroup heterogeneity (all Pheterogeneity &amp;gt; .10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among DM patients, SGLT2is reduced the risk of pneumonia and septic shock compared with placebo. Our findings should be viewed as hypothesis generating, with concepts requiring validation in future studies.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgac558","type":"journal-article","created":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T11:58:45Z","timestamp":1664625525000},"page":"3442-3451","source":"Crossref","is-referenced-by-count":33,"title":["Sodium-Glucose Cotransporter 2 Inhibitors and the Risk of Pneumonia and Septic Shock"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2294-2977","authenticated-orcid":false,"given":"Hang-Long","family":"Li","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, The University of Hong Kong Shenzhen Hospital , Shenzhen 518053 , China"},{"name":"Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital , Hong Kong 999077 , 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