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Sodium-glucose cotransporter 2 inhibition: cardioprotection by treating diabetes-a translational viewpoint explaining

Anne E de Leeuw1, Rudolf A de Boer2

  • 1Department of Cardiology, University of Groningen, University Medical Center Groningen (UMCG), AB43, Antonius Deusinglaan 1, Hanzeplein 1, 9713GZ Groningen, The Netherlands.

European Heart Journal. Cardiovascular Pharmacotherapy
|August 18, 2016
PubMed

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose by increasing urinary glucose excretion. These antidiabetic drugs also offer cardiovascular benefits, including reduced body weight and blood pressure.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiology

Background:

  • Diabetes mellitus is a global epidemic linked to high cardiovascular disease (CVD) rates and mortality.
  • Conventional therapies targeting hyperglycemia do not always reduce cardiovascular mortality and can worsen risk factors like body weight.
  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors represent a novel therapeutic class for diabetes management.

Purpose of the Study:

  • To summarize the functional consequences of SGLT2 inhibition in diabetic and hyperglycemic individuals.
  • To focus on the effects of SGLT2 inhibition on the kidney and cardiovascular system.
  • To review findings from experimental studies and their potential clinical implications.

Main Methods:

  • Review of experimental studies on SGLT2 inhibition.
  • Analysis of functional consequences on glucose metabolism, body weight, and blood pressure.
  • Examination of proposed direct cardioprotective mechanisms.

Main Results:

  • SGLT2 inhibition promotes glucose excretion via urine, effectively lowering blood glucose.
  • Ancillary benefits include caloric and volumetric loss, leading to reduced body weight and blood pressure.
  • Experimental evidence suggests SGLT2 inhibition may reduce cardiac fibrosis, inflammation, and oxidative stress, offering cardioprotection.

Conclusions:

  • SGLT2 inhibition is a promising therapeutic strategy for managing hyperglycemia and associated cardiovascular risk factors.
  • Observed benefits in experimental models may translate to clinical practice, as suggested by recent heart failure outcome trials.
  • Further research and long-term studies are needed to fully elucidate the impact of SGLT2 inhibition on cardiovascular outcomes.
Keywords:
Antidiabetic agentCV eventDiabetes mellitusHeart failureHyperglycaemiaSGLT2 inhibition

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