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SGLT2 inhibitors and diabetic retinopathy: Insights from the management of nephropathy

Eye volume 39, pages 213–214 (2025)Cite this article

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Diabetic retinopathy (DR) continues to be a leading cause for diabetic macular oedema (DMO) and complete vision loss. Recent demographic data suggests that in 2020, approximately 103.12 million diabetic patients worldwide were affected by retinopathy, and this number is projected to increase to 129.84 million and 160.50 million in 2030 and 2045, respectively [1, 2]. The eye shares common structural, developmental, and genetic pathways with the kidney, indicating that renal disease and ocular pathology are closely related [3, 4].

It is imperative to remember that the kidneys play a key role in glucose homoeostasis, through both gluconeogenesis and glucose excretion. Of note, sodium-glucose cotransporter (SGLT2), coded by the SLC5A2 gene, is accountable for up to 99% reabsorption of the filtered glucose load in proximal renal tubules; SLC5A2 genetic polymorphisms are therefore proposed to control glucose homoeostasis; and with their presence in the retinal pericytes, there can be a plausible effect on DR too [5].

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Authors and Affiliations

  1. University of Sheffield Medical School, Royal Hallamshire Hospital, Sheffield, UK

    Maria S. Varughese

  2. University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, North Staffordshire, UK

    Lakshminarayanan Varadhan

  3. School of Medicine, Faculty of Health, Keele University, North Staffordshire, UK

    Lakshminarayanan Varadhan

Authors
  1. Maria S. Varughese
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  2. Lakshminarayanan Varadhan
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Contributions

MSV wrote the manuscript and reviewed the literature. LV conceptualised the theme, revised the discussion and edited the article. MSV and LV contributed equally to this COMMENT.

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Correspondence to Lakshminarayanan Varadhan.

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Varughese, M.S., Varadhan, L. SGLT2 inhibitors and diabetic retinopathy: Insights from the management of nephropathy. Eye 39, 213–214 (2025). https://doi.org/10.1038/s41433-024-03472-9

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