Practical Geriatrics · Oct 20, 2026
Research progress on the effects of sodium-glucose cotransporter 2 inhibitors on skeletal muscle
By Wang Yabing, Shi Jingwen, Kan Junpeng et al.
Sodium-glucose cotransporter 2 inhibitors(SGLT2is) are a novel class of glucose-lowering agents that reduce blood glucose levels by inhibiting renal glucose reabsorption and promoting urinary glucose excretion. SGLT2is have been widely used in patients with chronic heart failure and chronic kidney disease due to their established cardiorenal protective effects. Existing evidence has confirmed that SGLT2is can reduce body weight, and their weight-lowering effects may be associated with increased fat oxidation. However, whether weight loss induced by SGLT2is is accompanied by changes in muscle tissue remains controversial. Skeletal muscle, the predominant peripheral metabolic organ, serves as the primary site for glucose utilization and energy metabolism, where changes in mass and function are closely linked to patients’ prognosis. This review synthesizes current evidence regarding the impact of SGLT2is on skeletal muscle mass, muscle strength, and the underlying biological mechanisms: although SGLT2is may cause a slight reduction in skeletal muscle mass, they might improve muscle function by modulating energy metabolism and mitigating oxidative stress. Future large-scale, long-term clinical trials are warranted to define the risk-benefit boundaries of SGLT2is in older adults and frail populations.