Benefits of SGLT2 inhibitors on renal and cardiovascular protection, in diabetic patients

Abstract

Introduction: Type 2 Diabetes Mellitus is major risk factors for both cardiovascular and renal diseases. Managing cardiovascular risk and the progression of renal disease is therefore essential in treating diabetic patient. Sodium-glucose cotransporter-2 inhibitors have been linked to a substantial decrease in cardiovascular and renal mortality, reduced hospitalizations for heart failure and slower progression of renal damage and albuminuria. Objectives: Our study aimed to evaluate the impact of SGLT2i on cardiovascular and renal protection in diabetic patients. Methods: Our study involved elderly patients, with type 2 diabetes, who were divided in two groups, one group received SGLT2i, while the other did not. Data were collected at the start of treatment, as well as at 3, 6, 9 and 12 months thereafter. During each evaluation, we assessed HbA1C, BMI, GFR and renal parameters, uric acid, NTproBNP, echocardiography, and both PAS and PAD values, in both groups. Results: Out of 300 elderly diabetic patients included in the study, 200 were started on dapagliflozin 10 mg. At 12 months, HbA1c, weight, systolic blood pressure, NTproBNP, uric acid, albuminuria, were decreases in group with dapagliflozin versus the other group without it, and estimated glomerular filtration rate was higher (75.3 – 87.19mL/min/1.73m2; p<0.005). Follow up in patients with SGLT2i showed a significant decrease in left ventricular end-diastolic dimension (LV-EDD) (62.86 mm to 54.85 mm; P< 0.001) and improvement in LV-EF. Conclusions: The use of Dapagliflozin demonstrated metabolic benefits in patients with T2DM, including notable decreases in HbA1c, blood pressure, weight, uric acid, and NTproBNP. Additionally, cardiovascular and renal benefits were observed. Therefore, SGLT2i have a significant impact on both cardiovascular and renal protection in diabetic patients.