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SGLT2 inhibitors: practical considerations and recommendations for cardiologists
Erika Opingari1, Arun C R Partridge2, Subodh Verma3
1Institute of Medical Science, University of Toronto.
Current Opinion in Cardiology
|August 28, 2018
Summary
Sodium-glucose cotransporter 2 (SGLT2) inhibitors offer significant cardiovascular and renal benefits for type 2 diabetes mellitus patients. These drugs are generally well-tolerated, with benefits outweighing potential risks.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Type 2 diabetes mellitus (T2DM) management requires addressing cardiovascular and renal risks.
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of antidiabetic medications.
Purpose of the Study:
- To review common concerns regarding SGLT2 inhibitor use in T2DM patients within cardiovascular practice.
- To highlight the cardiovascular and renal benefits of SGLT2 inhibitors.
Main Methods:
- Review of cardiovascular outcome trials and clinical data on SGLT2 inhibitors.
- Analysis of safety profiles and adverse effects associated with SGLT2 inhibitors.
Main Results:
- SGLT2 inhibitors provide glycemic control and improve cardiovascular, heart failure, and renal outcomes in T2DM.
- Benefits persist down to an estimated glomerular filtration rate (eGFR) of 30 mL/min/1.73 m².
- Common side effects include genital mycotic infections; rarer concerns include fractures and amputations with canagliflozin.
Conclusions:
- SGLT2 inhibitors are effective adjuncts to T2DM treatment, with benefits generally outweighing risks.
- Cardiologists play an expanding role in managing T2DM patients with SGLT2 inhibitors.
- Routine renal function monitoring is advised at therapy initiation, especially with loop diuretics.
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