The primary objective of this article is to examine the clinical benefit, safety, and tolerability of the four SGLT2 inhibitors approved by the US FDA. SGLT2 inhibitors increase urinary glucose excretion via inhibiting SGLT2 to decrease renal reabsorption of filtered glucose and reduce the renal threshold for glucose (Cardiovascular Diabetology)
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Tag: SGLT2 inhibitors
Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin
As first-line T2D treatment, initiators receiving SGLT-2i showed a similar risk for MI/stroke/mortality, lower risk for HHF/mortality and HHF, and a similar safety profile except for an increased risk for genital infections compared with those receiving metformin (Annals of Internal Medicine)
Comparison of cardiovascular outcomes between SGLT2 inhibitors in diabetes mellitus
The risks for subsequent development of HF, MI, AP, stroke, and AF were comparable between individual SGLT2 inhibitors. This is the first study comparing the wide-range cardiovascular outcomes of patients with DM treated with individual SGLT2 inhibitors using large-scale real-world data (Cardiovascular Diabetology)
Infarct size, inflammatory burden, and admission hyperglycemia in diabetic patients with acute myocardial infarction treated with SGLT2-inhibitors: a multicenter international registry
Type 2 diabetic AMI patients receiving SGLT2-I exhibited significantly reduced inflammatory response and smaller infarct size compared to those receiving other OAD agents independently of glucose-metabolic control (Cardiovascular Diabetology)
Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Bladder and Renal Cancer: Scandinavian Cohort Study
Use of SGLT2 inhibitors, as compared with GLP-1 receptor agonists, was not associated with a statistically significant increase in risk of bladder cancer (Diabetes Care)
Global use of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes. Results from DISCOVER
Global use of glucose-lowering medications with established cardiovascular benefits has increased over time but remains suboptimal, particularly in sub-groups most likely to benefit. Substantial country-level variability exists independent of patient factors, suggesting structural barriers may limit more widespread use of these medications (BMC Endocrine Disorders)
Sodium-glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People with Type 2 diabetes: A Meta-analysis of Individual Participant Data from Randomized Controlled Trials
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk and/or with CKD, without increasing the risk of hypokalemia
Clinical cardiovascular phenotypes and the pattern of future events in patients with type 2 diabetes
In T2D, a patient’s cardiovascular phenotype can help predict the pattern of future cardiovascular events (Clinical Research in Cardiology)
Defining the Role of SGLT2 Inhibitors in Primary Care: Time to Think Differently
Increasing evidence suggests that sodium–glucose cotransporter 2 inhibitors (SGLT2is) have beneficial effects across all stages of the cardiorenal metabolic continuum, reducing morbidity and mortality in a wide range of individuals, from those with diabetes and multiple risk factors to those with established heart failure and chronic kidney disease, regardless of the presence of diabetes (Diabetes Therapy)
Beyond the Glycaemic Control of Dapagliflozin: Microangiopathy and Non-classical Complications
Dapagliflozin contributes to the control of CV risk factors and reduces the risk of microvascular complications (nephropathy and retinopathy) and other non-classical complications of T2DM. The underuse of SGLT2i in general and dapagliflozin in particular, even in patients whose profiles suggest that they could greatly benefit from SGLT2i treatment, indicates that greater effort is needed to translate scientific evidence into actual clinical practice to improve patients’ quality of life (Diabetes Therapy )
Renoprotective effect of additional sodium-glucose cotransporter 2 inhibitor therapy in type 2 diabetes patients with rapid decline and preserved renal function
Early intervention with SGLT2i may have renoprotective effects in T2D patients with rapid decline and preserved renal function (Journal of Diabetes Investigation)
The Place and Value of Sodium-Glucose Cotransporter 2 Inhibitors in the Evolving Treatment Paradigm for Type 2 Diabetes Mellitus: A Narrative Review
The ‘SGLT2i Prescribing Tool for T2DM Management’, previously published by the Steering Committee, has been updated to reflect the latest evidence and is provided in the Supplementary Materials to help support clinicians delivering T2DM care (Diabetes Therapy)
Real-world Evidence of Efficacy and Safety of SGLT2 Inhibitors as Adjunctive Therapy in Adults With Type 1 Diabetes: A European Two-Center Experience
Our real-world data on SGLT2i showed promising results in reductions in HbA1c, weight, and insulin requirements in type 1 diabetes. Benefits were more pronounced in individuals with higher baseline HbA1c and BMI. DKA remained a major concern, despite educational measures (Diabetes Care)
Impacts of Sodium/Glucose Cotransporter-2 Inhibitors on Circulating Uric Acid Concentrations: A Systematic Review and Meta-Analysis
SGLT2i can be a valid therapeutic strategy for patients with T2DM and comorbid hyperuricemia. Besides reducing FPG, body weight, and HbA1c, SGLT2i can significantly decrease SUA levels compared to placebo (Journal of Diabetes Research)
Primary Prevention of Cardiovascular and Heart Failure Events With SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Their Combination in Type 2 Diabetes
SGLT2i and SGLT2i/GLP-1RA combination regimens may be beneficial in primary prevention of MACCE and HF and GLP-1RA for HF. These data call for primary prevention trials using these agents and their combination (Diabetes Care)
Emerging Horizons in Heart Failure with Preserved Ejection Fraction: The Role of SGLT2 Inhibitors
The ESC recently added SGLT2 inhibitors to the management guidelines for HFrEF following good outcomes from DAPA-HF [18] and EMPEROR-Reduced [19] over the last 2 years. We hope that further supporting evidence for SGLT2 inhibitors in the management of HFpEF follows with the results of the ongoing DELIVER trial expected soon, and that as a result similar changes to guidelines may be added to support the use of SGLT2 inhibitors in the management of HFpEF (Diabetes Therapy)
Predictors of cardio-kidney complications and treatment failure in patients with chronic kidney disease and type 2 diabetes treated with SGLT2 inhibitors
Our study demonstrated high rates of residual cardio-kidney outcomes and treatment failure in patients with DKD treated with SGLT2is. Patients with high baseline CV risk and the presence of certain conditions, such as atrial fibrillation, PVD, and heart failure, were at higher risk for cardio-kidney events (BMC Medicine)
Combined SGLT-2 and ACE inhibition upregulates the renin-angiotensin system in chronic kidney disease with type 2 diabetes: Results of a randomized, double-blind, placebo-controlled exploratory trial
A distinct RAS modulation by SGLT-2i occurs in diabetic kidney disease reflected by enhancement of the beneficial Angiotensin-(1–7) providing a molecular background for this renoprotective therapeutic approach (Diabetes, Obesity and Metabolism)
Network meta-analysis on the effects of SGLT2 inhibitors versus finerenone on cardiorenal outcomes in patients with type 2 diabetes and chronic kidney disease
Given the above limitations of this study, its findings may suggest that among patients with T2D and CKD SGLT2 inhibitors are more effective than finerenone in reducing renal and cardiovascular endpoints, especially renal and cardiac failure events(Frontiers in Pharmacology)
SGLT-2 inhibitors and cardiorenal outcomes in patients with or without type 2 diabetes: a meta-analysis of 11 CVOTs
Therapy with SGLT-2 inhibitors in patients with cardiometabolic and renal diseases results in a sustained to moderate reduction of the composite CV death or hospitalization for HF, robust reduction of HF and renal outcomes, moderate reduction of CV mortality, total mortality and MACE (Cardiovascular Diabetology)
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