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Sodium-Glucose Cotransporter-2 Inhibitors in Type 2 Diabetes: From Metabolic Mechanisms to International Guidelines

Tamás Várkonyi1, Krisztina Kupai1,2, Hsu Lin Kang2

  • 1Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6703 Szeged, Hungary.

Antioxidants (Basel, Switzerland)
|May 27, 2026
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer significant benefits for type 2 diabetes management. They improve glycemic control, aid weight loss, and protect against heart failure and kidney disease progression.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) requires individualized treatment for glycemic control and comorbidity management.
  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a key therapeutic class due to their renal action.

Purpose of the Study:

  • To review the metabolic mechanisms, pleiotropic effects, and clinical significance of SGLT2 inhibitors in T2DM management.
  • To provide an updated overview of SGLT2 inhibition's systemic effects.

Main Methods:

  • Literature review of preclinical data and major clinical outcome trials.
  • Analysis of metabolic, anti-inflammatory, and antifibrotic actions.
  • Integration of findings with current international guidelines.

Main Results:

  • SGLT2 inhibitors promote glycosuria, leading to weight loss and improved lipid profiles.
  • Preclinical data indicate anti-inflammatory and antifibrotic effects.
  • Clinical trials demonstrate reduced heart failure hospitalizations and slowed chronic kidney disease progression.

Conclusions:

  • SGLT2 inhibitors are vital in T2DM management, offering cardiovascular and renal protection.
  • Consideration of safety, combination therapies, and personalized approaches is crucial.
Keywords:
SGLT2T2DM

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