SGLT2 inhibitors raise hemoglobin a little, and it looks like an expected drug effect

If you take an SGLT2 inhibitor and your lab report shows hemoglobin a bit higher than before, you are not alone. A large new review of trials found this happens with the whole drug class, and it looks like an expected effect of the medicine.

Hemoglobin is the protein in your red blood cells that carries oxygen. SGLT2 inhibitors, such as empagliflozin and dapagliflozin, started as diabetes pills and are now also used to protect the heart and kidneys. The review found that people taking them ended up with somewhat higher hemoglobin than people on placebo or another drug.

How the study worked

Researchers pooled results from 85 randomized, double-masked trials, which means neither patients nor doctors knew who got the real drug. The trials included people with diabetes, heart disease, heart failure or chronic kidney disease. The median trial lasted 24 weeks, and the average starting hemoglobin was 13.6 g/dL. The results were published Oct. 24, 2026, in JAMA. The trials were fairly short, so the review cannot say what happens over many years.

What they found

On average, hemoglobin rose by about 0.6 g/dL more with SGLT2 inhibitors than with the comparison group. The exact figure was 0.60 g/dL. In the comparison group, hemoglobin barely moved.

Hematocrit also went up. That is the share of your blood made of red cells. It was about 2.4 percentage points higher with the drugs, or 2.36% to be exact.

The researchers also looked at the body’s red blood cell machinery:

This is the useful part for your question. Higher EPO and less iron sitting around suggest the body is building more red blood cells. That points to more than the blood simply getting more concentrated as the drugs remove extra fluid. Some researchers think this may even help explain part of the heart and kidney benefits of these drugs, though this study did not test that.

So is the rise good or bad? The authors say the health meaning is not yet clear, and the increase is small. Nothing in the findings points to a problem. It fits a pattern seen across many trials and many people.

What about people with anemia?

Anemia means having too few red blood cells, and it is common in people with kidney disease. A drug that nudges red cell production upward could matter there. This review did not test that, so it is a question for future research, not a promise.

What you can do today

Pull up your most recent blood test in your patient portal or on your printed lab report. Find the hemoglobin line, write down the number and the date, and keep it in your phone notes. At your next visit, bring that number along so you and your doctor can watch it over time. Keep taking your medicine as prescribed.