Sglt2 inhibitors: A narrative review of efficacy and safety

Donald S. Nelinson, Jose M. Sosa, Robert J. Chilton

Research output: Contribution to journalReview articlepeer-review

Abstract

Type 2 diabetes mellitus (T2DM) is a cardiorenal-metabolic condition that is frequently associated with multiple comorbidities, including atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD). The sodium-glucose cotransporter-2 (SGLT2) inhibitors, which lower glycated hemoglobin, fasting and postprandial plasma glucose levels, body weight, and blood pressure, as well as reduce the risk of a range of cardiovascular and renal outcomes without increasing hypoglycaemicrisk,have heralded a paradigm shift in the management of T2DM. These drugs are compatible with most other glucoselowering agents and can be used in patients with a wide range of comorbid conditions, including ASCVD, HF, and CKD, and in those with estimated glomerular filtration rates as low as 30 mL/min/1.73 m2. However, there are misunderstandings surrounding the clinical implications of SGLT2 inhibitors’ mechanism of action and concerns about the key adverse events with which this class of drugs has been associated. This narrative review summarizes the data that support the efficacy of SGLT2 inhibitors in reducing the risks of cardiovascular and renal outcomes in patients with T2DM and comorbid conditions and clarifies information relating to SGLT2 inhibitor-related adverse events.

Original languageEnglish (US)
Pages (from-to)229-239
Number of pages11
JournalJournal of the American Osteopathic Association
Volume121
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • Cardiovascular risk reduction
  • Chronic kidney disease
  • Comorbidity
  • Heart failure
  • Primary care
  • SGLT2
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Complementary and alternative medicine

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