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The Use of SGLT-2 Inhibitors in Type 2 Diabetes and Heart Failure

Kayla Riggs1, Hiba Ali1, Heinrich Taegtmeyer2

  • 11 Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Texas Health Science Center at Houston School of Medicine , Houston, Texas.

Metabolic Syndrome and Related Disorders
|July 1, 2015
PubMed

Insights

Sodium glucose cotransporter-2 (SGLT-2) inhibitors offer a safe treatment for type 2 diabetes mellitus in patients with heart failure. These medications reduce glucose supply to the heart, addressing a key therapeutic challenge.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Concurrent type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) pose significant therapeutic challenges.
  • Insulin and insulin-sensitizing drugs can exacerbate cardiac substrate overload in T2DM patients.
  • Effective T2DM management in CHF requires reducing excessive substrate supply to the heart.

Purpose of the Study:

  • To review the mechanisms of glucotoxicity and lipotoxicity in the heart.
  • To analyze the role of Sodium Glucose Cotransporter-2 (SGLT-2) inhibitors in managing T2DM in patients with CHF.
  • To evaluate the safety and efficacy of SGLT-2 inhibitors in this patient population.

Main Methods:

  • Literature review examining the pathophysiology of cardiac substrate overload in T2DM.
  • Analysis of clinical evidence regarding SGLT-2 inhibitor use in patients with T2DM and CHF.
  • Assessment of safety data and renal function considerations for SGLT-2 inhibitor therapy.

Main Results:

  • SGLT-2 inhibitors reduce glucose reabsorption in the kidneys, leading to urinary glucose excretion.
  • This mechanism effectively decreases substrate supply to the heart.
  • Current evidence suggests SGLT-2 inhibitors are safe for T2DM patients with CHF and normal renal function.

Conclusions:

  • SGLT-2 inhibitors represent a valuable therapeutic option for T2DM management in patients with CHF.
  • These agents address the detrimental effects of substrate overload on the heart.
  • Further research is ongoing to determine the long-term survival benefits of SGLT-2 inhibitors in this cohort.

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