A Longitudinal Study on Hematocrit Changes after Glifozins Exposure in Patients with Type 2 Diabetes

Research Article

J Cardiovasc Disord. 2021; 7(1): 1044.

A Longitudinal Study on Hematocrit Changes after Glifozins Exposure in Patients with Type 2 Diabetes

De las Nieves López MA*, Robles Mateos C, Soria Cano JJ, Barón Fernandez O, Dominguez Lome&nTilde;a MJ and Palomo Hernandez AM

Instituto de Gestión Sanitaria (INGESA), Área Sanitaria de Melilla, Melilla, Espa&nTilde;a, Spain

*Corresponding author: Miguel Angel de las Nieves, Instituto de Gestión Sanitaria (INGESA), Área Sanitaria de Melilla, CN Policía s/n-52006 Melilla, Spain

Received: May 29, 2021; Accepted:July 05, 2021; Published: July 12, 2021


Background and Methods: Gliflozins are widely prescribed drugs in patients with type 2 diabetes. We pursue to explain abnormal increments in red cell parameters observed in this population, by means of a longitudinal study in 149 patients with a gliflozins exposure period of 12±6 months. Red cell parameters, HbA1c and other variables were recorded.

Results: HbA1c fraction decreased (-0.5±1.3, 95% CI: -0.7 to -0.3, p<0.001), while mean hemoglobin (0.5±0.9, 95% CI: 0.3 to 0.6, P<0.001) and hematocrit (1.6±2.6, 95% CI: 1.2 to 2.0, P<0.001) increased. Mean (SD) hematocrit increased 2.7±1.9 in 112 patients, and decreased -1.7±1.5 in 37 (p<0.001 for subgroup differences). The larger increments in PCV were proportional to higher plasma fraction at baseline (p=0.009).

Conclusion: Red cell parameters after gliflozins exposure tend to increase and may reach abnormally high thresholds in some patients with type 2 diabetes.

Keywords: Type 2 diabetes; Gliflozins; Red cells; Hematocrit


Hemoglobin (Hb) >16.5 g/dL and >16 g/dL or hematocrit >0.49 and >0.48, in males and females respectively, serve as major criteria to diagnose Polycythemia Vera [1]. These thresholds are sensitive to detect this condition, but more strict criteria in males (hematocrit >0.52) are used by some scientific organizations [2], and are more specific as predictors of adverse outcomes [3].

Here we report a preliminary observation of some patients referred for investigation because abnormally high hematocrit, or Packed Cell Volume (PCV), which after assessment were considered secondary and probably linked to gliflozins (Table 1). Thereafter, an explanatory analysis was performed by means of a retrospective longitudinal study, to assess if these changes are possible in type 2 diabetes patients receiving these drugs. Gliflozins are widely used oral antidiabetic agents inducing urinary glucose loss by means of Sodium Glucose Cotransporter 2 inhibition (SGLT2i), which show benefit for Cardiovascular (CV) outcomes in patients with type 2 diabetes [4]. The increment in red cell parameters was the main mediator of these drugs reducing mortality and hospitalization for heart failure in this population [5,6].