Abstract
Diabetes mellitus (DM) represents a major public health problem, with yearly increasing prevalence. DM is considered a progressive vascular disease that develops macro and microvascular complications, with a great impact on the quality of life of diabetic patients. Over time, DM has become one of the most studied diseases; indeed, finding new pharmacological ways to control it is the main purpose of the research involved in this issue. Sodium–glucose cotransporter 2 inhibitors (SGLT-2i) are a modern drug class of glucose-lowering agents, whose use in DM patients has increased in the past few years. Besides the positive outcomes regarding glycemic control and cardiovascular protection in DM patients, SGLT-2i have also been associated with metabolic benefits, blood pressure reduction, and improved kidney function. The recent perception and understanding of SGLT-2i pathophysiological pathways place this class of drugs towards a particularized patient-centered approach, moving away from the well-known glycemic control strategy. SGLT-2i have been shown not only to reduce death from cardiovascular causes, but also to reduce the risk of stroke and heart failure hospitalization. This article aims to review and highlight the existing literature on the effects of SGLT-2i, emphasizing their role as oral antihyperglycemic agents in type 2 DM, with important cardiovascular and metabolic benefits.
Highlights
Diabetes mellitus (DM) is a major public health problem, with yearly increasing prevalence
Sodium–glucose cotransporter 2 inhibitors (SGLT-2i) are associated with positive renal outcomes, therapy with this drug class may be considered in diabetic patients with renal impairment, to improve kidney function [28,29,30]
The recent understanding of the pathophysiological pathways of SGLT-2i places this class of drugs towards a particularized, patient-centered approach, moving away from the well-known glycemic control strategy
Summary
Diabetes mellitus (DM) is a major public health problem, with yearly increasing prevalence. Sodium–glucose cotransporter 2 inhibitors (SGLT-2i) are a modern drug class of glucose-lowering agents, whose use in DM patients has increased in recent years. The American Diabetes Association (ADA) recommends SGLT-2i as a second-line drug option, after metformin, for managing type 2 DM patients with established CVD [9]. Besides the positive outcomes regarding glycemic control and cardiovascular protection in DM, SGLT-2i have been associated with metabolic benefits (such as weight loss), blood pressure reduction, and improved kidney function [10,11,12,13]. This article aims to review and highlight the existing literature on the effects of SGLT2i, emphasizing their role as oral antihyperglycemic agents in type 2 DM, with important cardiovascular and metabolic benefits
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