SGLT2 inhibitors: a narrative review of efficacy and safety

Area of Science:

• Cardiology
• Nephrology
• Endocrinology

Background:

• Type 2 diabetes mellitus (T2DM) is a complex cardio-renal-metabolic condition often accompanied by atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD).
• Sodium-glucose co-transporter-2 (SGLT2) inhibitors represent a significant advancement in T2DM management, offering benefits beyond glycemic control.

Purpose of the Study:

• To review the efficacy of SGLT2 inhibitors in reducing cardiovascular and renal outcomes in T2DM patients with comorbidities.
• To clarify the mechanism of action and address adverse event concerns associated with SGLT2 inhibitors.

Main Methods:

• Narrative review of existing clinical trial data and scientific literature.
• Analysis of SGLT2 inhibitor effects on glycemic control, body weight, blood pressure, and cardiovascular/renal outcomes.
• Examination of safety profiles and adverse events associated with SGLT2 inhibitors.

Main Results:

• SGLT2 inhibitors effectively lower glycated hemoglobin, body weight, and blood pressure.
• These agents demonstrate significant risk reduction for cardiovascular and renal outcomes in T2DM patients, including those with ASCVD, HF, and CKD.
• SGLT2 inhibitors are compatible with most glucose-lowering agents and suitable for patients with reduced estimated glomerular filtration rates (eGFR ≥ 30 mL/min/1.73 m²).

Conclusions:

• SGLT2 inhibitors have transformed T2DM management by providing substantial cardio-renal protection.
• Understanding their mechanism and safety profile is crucial for optimizing clinical use and mitigating potential adverse events.