Precision medicine in type 2 diabetes: targeting SGLT2 inhibitor treatment for kidney protection – Published online 09/11/2025

Thijs T. Jansz, Katherine G. Young, Rhian Hopkins, Andrew P. McGovern, Beverley M. Shields, Andrew T. Hattersley, Angus G. Jones, Ewan R. Pearson, Coralie Bingham, Richard A. Oram, John M. Dennis on behalf of the MASTERMIND Consortium

Sodium–glucose cotransporter 2 (SGLT2) inhibitors slow kidney disease progression in people with type 2 diabetes, but many individuals, especially those with early-stage or no chronic kidney disease, have a low but heterogeneous baseline risk of kidney failure, making the absolute benefit of SGLT2 inhibitor treatment difficult to assess. In this issue, Jansz et al (https://doi.org/10.1007/s00125-025-06577-2) present a validated prediction model that estimates the likely kidney protection benefit of SGLT2 inhibitors for individual patients using routine clinical information. The model provides personalised estimates of absolute risk reduction, helping clinicians and patients understand the potential value of treatment more clearly. The authors conclude that the model enables individualised prescribing of SGLT2 inhibitors for kidney protection and could provide a more precise and effective alternative to the albuminuria threshold currently recommended in international guidelines.

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