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Sodium-glucose cotransporter inhibitors: beyond glycaemic control

Ander Vergara1,2, Conxita Jacobs-Cachá1,2, María José Soler1,2

  • 1Nephrology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.

Clinical Kidney Journal
|June 15, 2019
PubMed

Insights

Sodium-glucose co-transporter 2 (SGLT2) inhibitors offer cardiorenal protection in type 2 diabetes beyond glucose control. These drugs may protect kidneys through mechanisms like blood pressure reduction and decreased kidney injury.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Diabetes mellitus poses significant risks for cardiovascular and renal complications.
  • Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a class of drugs used for type 2 diabetes management.
  • While effective for glycemic control, SGLT2 inhibitors show additional benefits in reducing cardiovascular events and slowing diabetic kidney disease progression.

Purpose of the Study:

  • To review and update the proposed mechanisms by which SGLT2 inhibitors provide cardiorenal protection.
  • To explore renoprotective effects of SGLT2 inhibitors that are independent of their glucose-lowering capabilities.
  • To discuss the evidence supporting direct renoprotective actions of SGLT2 inhibitors in various models.

Main Methods:

  • Literature review and synthesis of existing research on SGLT2 inhibitors.
  • Analysis of proposed mechanisms including blood pressure control, weight loss, and intraglomerular pressure reduction.
  • Examination of studies investigating SGLT2 inhibitor effects in both diabetic and non-diabetic models.

Main Results:

  • SGLT2 inhibitors demonstrate efficacy in reducing cardiovascular complications and slowing diabetic kidney disease progression.
  • Glycemic control achieved by SGLT2 inhibitors is comparable to other antidiabetic agents like sulfonylureas.
  • Potential renoprotective mechanisms independent of glycemic control include blood pressure reduction, weight loss, reduced intraglomerular pressure, and decreased tubular injury biomarkers.

Conclusions:

  • SGLT2 inhibitors offer significant cardiorenal benefits in patients with type 2 diabetes and chronic kidney disease.
  • Mechanisms beyond glycemic control, such as direct renoprotective effects, are crucial for understanding the full impact of SGLT2 inhibitors.
  • Further research continues to elucidate the multifaceted actions of SGLT2 inhibitors in preserving kidney and heart health.
Keywords:
SGLT2chronic kidney diseasediabetic nephropathytype 2 diabetes

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