[SGLT2 inhibitors : promises, but for whom ?]

In type 2 diabetes, the launch of gliflozins (or SGLT2i), like each new therapeutic class, is generating a great deal of hope and is being heavily marketed. The pivotal studies show a beneficial effect on the risk of hospitalization for heart failure and, to a lesser extent, on the decline in renal function. The impact on physiological factors (weight, glycated hemoglobin, blood pressure) is modest, and the side-effect profile is relatively heavy, particularly in the elderly (frequent urogenital infections, ketoacidosis, etc.). The aim of this article is first and foremost to take a critical look at the interpretation of clinical studies and to identify populations where a favorable benefit/risk balance cannot be guaranteed.