Emerging Role of SGLT2 Inhibitors Beyond Glycemic Control: “Cardiovascular and Renal Benefits and Risks”
DOI:
https://doi.org/10.64229/v3v43h95Keywords:
SGLT2 inhibitors, Empagliflozin, Dapagliflozin, Cardiovascular protection, Heart failure with preserved ejection fractionAbstract
Sodium-glucose cotransporter2 (SGLT2) inhibitors, such as empagliflozin (EMPA) and dapagliflozin (DAPA), represent a significant advancement in the management of metabolic and cardiovascular disorders. Originally developed to enhance glycemic control in type 2 diabetes mellitus, their benefits now extend beyond glucose reduction, offering cardiovascular and renal protection. Accumulating clinical data highlight their effectiveness in reducing the risk of heart failure, slowing renal disease progression, and improving survival, independent of their glycemic effects. The pleiotropic actions of SGLT2 inhibitors, are attributed to a combination of mechanisms: improved hemodynamics, natriuresis, normalization of tubule glomerular feedback, reduction of oxidative stress, and inflammation. These agents have also shown positive effects on weight reduction, blood pressure, and metabolic homeostasis, further enhancing their therapeutic profiles in cardiorenal and metabolic disorders. Despite their well-established efficacy, SGLT2 inhibitors have anticipated adverse effects, such as vaginal infections, mild volume depletion, and, in rare cases, euglycemic diabetic ketoacidosis (DKA). However, these risks are generally manageable through appropriate patient selection, education, and monitoring. The overall safety profile remains favorable, with consistent outcomes across large-scale randomized controlled trials and real-world studies. This article aims to provide insight and analysis into the expanding role of SGLT2 inhibitors, focusing not only on their traditional role but also on their benefits and side effects on the kidneys and heart. In an effort to establish the benefits of these inhibitors in protecting both the heart and kidneys in diabetic and non-diabetic patients, this article seeks to present the latest studies on these inhibitors. Additionally, it aims to offer a balanced approach that physicians can leverage in the role of these inhibitors in treating both the heart and kidneys.
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