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Prevention of Cardiorenal Complications with Sodium-Glucose Cotransporter Type 2 Inhibitors: A Narrative Review

Manuel Botana1, Javier Escalada2,3, Ángel Merchante4

  • 1Endocrine Seccion, Lucus Augusti University Hospital, Lugo, Spain.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|June 15, 2022
PubMed

Insights

Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) reduce cardiovascular and kidney disease risks in type 2 diabetes (T2D) patients. These drugs offer cardiorenal protection beyond blood sugar control.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Heart failure (HF) and chronic kidney disease (CKD) are common cardiorenal conditions in type 2 diabetes (T2D).
  • Comorbidities like hypertension, dyslipidemia, and obesity can worsen cardiorenal outcomes in T2D.
  • Achieving glycemic targets and preventing cardiorenal disease progression are crucial for T2D patients.

Purpose of the Study:

  • To review the evidence on sodium-glucose cotransporter type 2 inhibitors (SGLT2i) for cardiorenal prevention in T2D.
  • To discuss the mechanisms of action, efficacy, safety, and clinical guidelines for SGLT2i.
  • To highlight the role of SGLT2i in cardiorenal protection beyond glycemic control.

Main Methods:

  • Review of clinical trials evaluating SGLT2i (dapagliflozin, empagliflozin, canagliflozin, ertugliflozin).
  • Analysis of evidence regarding SGLT2i mechanisms, efficacy, and safety.
  • Summary of current clinical guidelines for SGLT2i use.

Main Results:

  • SGLT2i consistently reduce risks of major adverse cardiovascular events and/or HF hospitalizations.
  • SGLT2i demonstrate a lower risk of kidney disease progression in T2D patients.
  • SGLT2i offer benefits distinct from other antihyperglycemic drugs, potentially via pleiotropic effects.

Conclusions:

  • SGLT2i represent a significant therapeutic class for managing T2D with cardiorenal implications.
  • These agents provide cardiorenal benefits independent of their glucose-lowering effects.
  • Clinical guidelines support the use of SGLT2i for cardiorenal risk reduction in T2D.

Keywords:
CardiorenalCardiovascular diseaseKidney diseaseSGLT2 inhibitorsType 2 diabetes

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