Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in type 2 diabetes (T2D) management, but their efficacy and tolerance in Prader-Willi syndrome (PWS) remains unknown. Given the early onset of diabetes and treatment challenges, evaluating SGLT2is in this population is essential.

In this retrospective, multicenter study, 48 adults with PWS and T2D, among whom 24 patients receiving SGLT2is, were followed over 6 months. Glycemic and renal parameters were analyzed at baseline and 6 months.

HbA1c was higher in the SGLT2i group and significantly improved (P < 0.05) while it remained stable in controls. The albumin-to-creatinine ratio also decreased significantly. No significant weight change was noted. Adverse events occurred in 37.5 % of treated patients, including acute kidney injury in 8.3 %.

SGLT2is improve glycemic control and renal markers in PWS with no weight loss. Close safety monitoring is warranted, particularly regarding renal function in PWS and more generally towards all complex obesity with neurodevelopmental disorders.

SGLT2 inhibitor

Prader willi syndrom

Type 2 diabetes

© 2025 The Author(s). Published by Elsevier Masson SAS.