The edition · Top Clinical Updates
SGLT2 inhibitors raise haemoglobin by about 0.6 g/dL, enough to mislead a blood count
A meta-analysis of 85 trials sizes an effect most prescribers notice but few anticipate, alongside obesity and early-onset cancer, AI scribes and a short-acting psychedelic for resistant depression.
The edition in brief
Pooling 85 double-blind trials and 70,543 participants, SGLT2 inhibitors raised haemoglobin by 0.60 g/dL (0.55–0.66) and haematocrit by 2.4 percentage points against control, with higher erythropoietin and slightly lower transferrin saturation; the clinical meaning is uncertain, but the rise can mask anaemia or prompt needless polycythaemia work-up. A Korean cohort of 6.3 million adults aged 20 to 39 linked obesity to more early-onset cancer: ten-year incidence 2.62% with class II obesity against 1.84% at normal weight, with abdominal obesity adding risk. In a 14-hospital Boston system, enrolment in an ambient AI scribe was associated with about 1.2 minutes less note time per encounter, more among heavy users, but no change in after-hours closure or productivity. A phase 2b trial of a single intranasal dose of mebufotenin in 193 adults with treatment-resistant depression reduced MADRS scores by about 5 to 6 points more than a very low dose at day 29, with most people ready for discharge within two hours. The pearl covers reading a full blood count in someone on an SGLT2 inhibitor.
Obesity in young adults linked to more early-onset cancer
Measure waist as well as BMI in young adults, and include early-onset cancer risk in weight conversations without overstating it.
AI scribe enrolment saved about a minute per note, more for heavy users
If you adopt an AI scribe, use it consistently and edit every note, and do not expect it alone to clear after-hours work.
A single intranasal psychedelic dose eased resistant depression in a phase 2b trial
Mebufotenin is promising but unapproved; keep to licensed options for resistant depression and discuss the evidence when patients ask.
Reading a blood count in someone on an SGLT2 inhibitor
Check the drug list and the pre-treatment value before acting on a haemoglobin result in someone on an SGLT2 inhibitor.
SGLT2 inhibitors raise haemoglobin by about 0.6 g/dL
Expect a small haemoglobin rise on SGLT2 inhibitors and interpret blood counts against the pre-treatment baseline.
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