Podcast episode 135 (in German)

Canagliflozin – fourteen percent for males, and what happened to the females

November 12, 2026

An approved diabetes drug extends the lives of male mice by 14 percent, measured at 3 sites and confirmed once more when started late. For the females the picture looks different — and that is exactly where the story gets interesting.

What it is about

Canagliflozin blocks the SGLT2 transporter in the kidney, so that sugar is excreted in the urine. In the American Interventions Testing Program, male mice lived considerably longer on it although they barely lost weight; the females lost a lot of fat and did not live longer, and when started late they even lived shorter. This calls into question the obvious explanation via weight loss; the authors suspect flattened sugar spikes after feeding instead. In humans the drug is extremely well studied, but for diseased hearts and kidneys, not for aging. The episode also looks at what people write about SGLT2 inhibitors and which explanations they lack in everyday life. At the end one point moves to the front: a rare acidosis that does not go well with fasting.

Key points

In males, median lifespan rose by 14 percent, and the age reached by only every 10th animal by 9 percent; the females were at 1 percent, not significant.
The females became 17 to 19 percent lighter and lost 41 percent of their fat mass, the males lost only 5 to 8 percent of their weight with unchanged fat mass — the life extension ran exactly the other way round.
When treatment started at 16 months, the males again lived 14 percent longer and the females 6 percent shorter, statistically confirmed; in old females the drug level was about 20 times higher than in young males.
In the CANVAS program with 10,142 people with type 2 diabetes and high cardiovascular risk, cardiovascular death, heart attack and stroke occurred at 26.9 versus 31.5 per 1,000 patient-years, amputations at 6.3 versus 3.4.
In the kidney trial with 4,401 people, the combined kidney and cardiovascular endpoint fell by 30 percent, with no significant difference in amputations; the US agency removed the boxed warning in August 2020.
With the related empagliflozin, in 6,609 people with kidney disease, 54 percent of them without diabetes, the endpoint of kidney deterioration or cardiovascular death over about 2 years was 13.1 versus 16.9 percent.
In an analysis of 22,000 tweets on diabetes tablets, 4 of 10 side effects mentioned for canagliflozin concerned amputations; more than 9 of 10 of these mentions expressed concern.

Where the data stop

The lifespan finding comes from genetically heterogeneous mice that do not develop diabetes on their own, and there it applies only to males. Why the females lived shorter when started late could not be clarified even by a 2026 histological follow-up study; the sugar spikes are one lead. In humans, what was protected were diseased hearts and kidneys over 2 to 4 years; nobody has treated a healthy person for decades and counted who lives longer. There is no analysis of people who take canagliflozin against aging. Tweets do not count frequencies, but they show what concerns people; in a small interview study from Australia with 4 patients and 24 practitioners, what is missing above all is explanation, including on intimate hygiene.

Rare but serious is a ketoacidosis in which blood sugar looks normal. The European Medicines Agency names as risk factors, for example, eating little, severe fluid loss, surgery and a lot of alcohol, and thus fasting as well. In Germany, Invokana was taken off the market in 2014; anyone who has been prescribed such a drug does not stop it on their own.

Listen (in German)

Listen on Spotify Listen on Apple Podcasts Listen on Amazon Music

Published on November 12, 2026.

The topic in the database

Modern diabetes drug that excretes excess sugar via the urine – and extended the lifespan of male mice in the ITP. Heart and…Canagliflozin (SGLT2 inhibitor)

All episodes in the app (German)

Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-23.