Diabetes drugs, specifically SGLT-2 inhibitors, which may soon see wider prescription in England, could potentially save thousands of lives each year. This conclusion comes from a new study led by researchers at the London School of Hygiene & Tropical Medicine (LSHTM) and University College London (UCL).
Last August, the UK diabetes guideline committee at the National Institute for Health and Care Excellence (NICE) proposed SGLT-2 inhibitors in combination with metformin as a first-line treatment for type 2 diabetes. The final guidance is anticipated to be released on February 18, 2026.
The study utilized anonymized health records from over 60,000 individuals, revealing that over a three-year period, one life was saved for every 47 people prescribed an SGLT-2 inhibitor. With approximately three million individuals receiving treatment for type 2 diabetes in the UK, this suggests that about 20,000 deaths could potentially be prevented each year.
Bridging the Gap in Diabetes Treatment
SGLT-2 inhibitors are known to lower blood sugar levels and have demonstrated a protective effect on the kidneys and heart in clinical trials, reducing the risk of premature death from cardiac events such as strokes and heart attacks. However, these trials typically involved carefully selected groups of patients, leaving a knowledge gap regarding the drug’s effects on a broader population.
The study, published in BMJ Open Diabetes Research & Care and funded by the National Institute for Health and Care Research (NIHR), employed anonymized GP records to assess the effectiveness of SGLT-2 inhibitors in reducing mortality among a wider range of patients. The researchers used a “trial emulation” approach, adhering to clinical trial design principles to mitigate common biases in big data analysis.
“This study is a good example of how patient data can help inform patient care. It shows how we can use electronic health records safely to complement evidence from randomised controlled trials to improve outcomes for patients.” – Dr. Patrick Bidulka, Assistant Professor at LSHTM
Implications for Diabetes Care
Currently, metformin is the standard first-line treatment for type 2 diabetes in the UK. SGLT-2 inhibitors are recommended only when additional risk factors, such as established cardiovascular disease or chronic heart failure, are present. The study’s findings have been submitted to NICE as part of the consultation process for the updated guidelines.
Dr. David Ryan, lead author and MD & PhD student at UCL, emphasized the broader applicability of the drug: “Our study shows this drug works very well in a much wider range of people with type 2 diabetes than we previously had evidence for.”
“Our findings support NICE’s draft guidance proposing its use as a first treatment for type 2 diabetes, in addition to metformin – which would be a major shift in diabetes care affecting millions. The typical person with type 2 diabetes may live longer with these tablets.” – Dr. David Ryan
Looking Ahead
The potential integration of SGLT-2 inhibitors as a first-line treatment alongside metformin represents a significant shift in diabetes care. If NICE’s final guidance aligns with the study’s findings, it could lead to widespread changes in treatment protocols, potentially improving the longevity and quality of life for millions of patients.
The announcement comes as healthcare systems globally are increasingly leveraging electronic health records to enhance patient care and outcomes. The study by LSHTM and UCL exemplifies how real-world data can complement clinical trials, offering a fuller picture of drug efficacy across diverse populations.
As the healthcare community awaits the final decision from NICE, the study’s findings underscore the importance of expanding treatment options for type 2 diabetes, a condition affecting millions worldwide.
This story is based on an original press release by UCL.
Publication: Ryan DK et al. Enhancing evidence-based care using trial emulation in electronic health records: real-world effects of empagliflozin in people with type 2 diabetes. BMJ Open Diabetes Research & Care. 2026. DOI: 10.1136/bmjdrc-2025-005672
