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Intersection Between Diabetes and Heart Failure: Is SGLT2i the "One Stone for Two Birds" Approach?

Qing Zhang1, Yu Kang2, Siqi Tang2

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. qzhang2000cn@163.com.

Current Cardiology Reports
|October 14, 2021
PubMed

Insights

Sodium-glucose transport protein 2 inhibitors (SGLT2i) benefit patients with heart failure (HF) and reduced ejection fraction (HFrEF), regardless of diabetes mellitus (DM) status. These SGLT2 inhibitors expand foundational HFrEF therapy.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus (DM) is a significant comorbidity in heart failure (HF) patients.
  • Understanding differences in HF characteristics and treatment between diabetic and non-diabetic patients is crucial.
  • Sodium-glucose transport protein 2 inhibitors (SGLT2i) represent a novel therapeutic class.

Purpose of the Study:

  • To compare disease characteristics and treatment in HF patients with and without DM.
  • To investigate the benefits of SGLT2 inhibitors in both HF populations.
  • To determine if SGLT2 inhibitors offer advantages in diabetic versus non-diabetic HF patients.

Main Methods:

  • Review of recent large clinical trials.
  • Analysis of guideline-directed medical therapy in HF with reduced ejection fraction (HFrEF).
  • Evaluation of evidence for SGLT2 inhibitor efficacy in diabetic and non-diabetic HFrEF patients.

Main Results:

  • Guideline-directed medical therapy for HFrEF is consistent regardless of DM status.
  • SGLT2 inhibitors reduce HF hospitalization and cardiovascular mortality in HFrEF patients.
  • SGLT2 inhibitors improve quality of life in both diabetic and non-diabetic HFrEF patients.
  • SGLT2i expands the foundation of HFrEF therapy.

Conclusions:

  • SGLT2 inhibitors are beneficial for HFrEF patients, irrespective of diabetes status.
  • SGLT2 inhibitors represent an important expansion of foundational HFrEF therapy.
  • Further evidence is needed to confirm SGLT2 inhibitor efficacy in HF with preserved ejection fraction (HFpEF).
Abstract

Keywords:
Diabetes mellitusHeart failureSodium-glucose transport protein 2 inhibitors

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