SGLT2 Inhibitors in Type 2 Diabetes Mellitus and Heart Failure-A Concise Review

The incidence of both diabetes mellitus type 2 and heart failure is rapidly growing, and the diseases often coexist. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new antidiabetic drug class that mediates epithelial glucose transport at the renal proximal tubules, inhibiting glucose abso...

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Published inJournal of clinical medicine Vol. 11; no. 6; p. 1470
Main Authors Keller, Daria M, Ahmed, Natasha, Tariq, Hamza, Walgamage, Malsha, Walgamage, Thilini, Mohammed, Azad, Chou, Jadzia Tin-Tsen, Kałużna-Oleksy, Marta, Lesiak, Maciej, Straburzyńska-Migaj, Ewa
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 08.03.2022
MDPI
Subjects
Antidiabetics
Clinical medicine
Contraindications
COVID-19
Diabetes
Disease
Drug dosages
Ejection fraction
FDA approval
Glucose
Heart failure
Insulin resistance
Kidneys
Mortality
Oxidative stress
Physiology
Review
Sodium
heart failure
sodium-glucose co-transporter 2 inhibitors
sodium-glucose co-transporter 2
diabetes mellitus type 2
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Abstract The incidence of both diabetes mellitus type 2 and heart failure is rapidly growing, and the diseases often coexist. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new antidiabetic drug class that mediates epithelial glucose transport at the renal proximal tubules, inhibiting glucose absorption-resulting in glycosuria-and therefore improving glycemic control. Recent trials have proven that SGLT2i also improve cardiovascular and renal outcomes, including reduced cardiovascular mortality and fewer hospitalizations for heart failure. Reduced preload and afterload, improved vascular function, and changes in tissue sodium and calcium handling may also play a role. The expected paradigm shift in treatment strategies was reflected in the most recent 2021 guidelines published by the European Society of Cardiology, recommending dapagliflozin and empagliflozin as first-line treatment for heart failure patients with reduced ejection fraction. Moreover, the recent results of the EMPEROR-Preserved trial regarding empagliflozin give us hope that there is finally an effective treatment for patients with heart failure with preserved ejection fraction. This review aims to assess the efficacy and safety of these new anti-glycemic oral agents in the management of diabetic and heart failure patients.
AbstractList The incidence of both diabetes mellitus type 2 and heart failure is rapidly growing, and the diseases often coexist. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new antidiabetic drug class that mediates epithelial glucose transport at the renal proximal tubules, inhibiting glucose absorption-resulting in glycosuria-and therefore improving glycemic control. Recent trials have proven that SGLT2i also improve cardiovascular and renal outcomes, including reduced cardiovascular mortality and fewer hospitalizations for heart failure. Reduced preload and afterload, improved vascular function, and changes in tissue sodium and calcium handling may also play a role. The expected paradigm shift in treatment strategies was reflected in the most recent 2021 guidelines published by the European Society of Cardiology, recommending dapagliflozin and empagliflozin as first-line treatment for heart failure patients with reduced ejection fraction. Moreover, the recent results of the EMPEROR-Preserved trial regarding empagliflozin give us hope that there is finally an effective treatment for patients with heart failure with preserved ejection fraction. This review aims to assess the efficacy and safety of these new anti-glycemic oral agents in the management of diabetic and heart failure patients.
Author Keller, Daria M
Walgamage, Thilini
Straburzyńska-Migaj, Ewa
Tariq, Hamza
Mohammed, Azad
Lesiak, Maciej
Walgamage, Malsha
Kałużna-Oleksy, Marta
Ahmed, Natasha
Chou, Jadzia Tin-Tsen
AuthorAffiliation 2 Cardiology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK; natashaahmed@doctors.org.uk
4 Center for Medical Education in English, Poznan University of Medical Sciences, 60-512 Poznan, Poland; malsha.walgamage@gmail.com (M.W.); thilini.walgamage@gmail.com (T.W.); azadmohammed158@gmail.com (A.M.)
3 Cardiology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; hamza_tariq@hotmail.co.uk
1 Ist Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznan, Poland; jadzia.chou@gmail.com (J.T.-T.C.); marta.kaluzna@wp.pl (M.K.-O.); maciej.lesiak@skpp.edu.pl (M.L.); ewa.straburzynska-migaj@skpp.edu.pl (E.S.-M.)
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– name: 3 Cardiology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK; hamza_tariq@hotmail.co.uk
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35329796$$D View this record in MEDLINE/PubMed
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Keywords heart failure
sodium-glucose co-transporter 2 inhibitors
sodium-glucose co-transporter 2
diabetes mellitus type 2
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Snippet The incidence of both diabetes mellitus type 2 and heart failure is rapidly growing, and the diseases often coexist. Sodium-glucose co-transporter 2 inhibitors...
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SubjectTerms Antidiabetics
Clinical medicine
Contraindications
COVID-19
Diabetes
Disease
Drug dosages
Ejection fraction
FDA approval
Glucose
Heart failure
Insulin resistance
Kidneys
Mortality
Oxidative stress
Physiology
Review
Sodium
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Title SGLT2 Inhibitors in Type 2 Diabetes Mellitus and Heart Failure-A Concise Review
URI https://www.ncbi.nlm.nih.gov/pubmed/35329796
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https://pubmed.ncbi.nlm.nih.gov/PMC8952302
Volume 11
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