Sodium-Glucose Co-Transporter 2 Inhibitors; One Shot, Two Gains

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are the newest category of antidiabetic drugs that inhibits sodium-glucose co-transporter 2 in the proximal convoluted tubule and thus prevent reabsorption of glucose that leads to glycosuria. Apart from their hypoglycemic actions they also plays a major role in improving cardiac functions[1]. There is an extreme association between diabetes and the onset of cardiovascular diseases. Among people with diabetes cardiovascular diseases are one of the major causes of death. Compared to those who are non-diabetic adults with the history of diabetic ones have high prevalence rate of cardiovascular diseases[2]. In this context, SGLT2 inhibitors are vital for the reduction of cardiovascular diseases in diabetic as well as non-diabetic patients. There are mainly four SGLT2 inhibitors available in the market which are dapagliflozin, canagliflozin, empagliflozin and ertugliflozin. The key mechanisms involving their cardioprotective actions are improving cardiac cell metabolism and ventricular loading conditions, inhibiting the exchange of Na+/H+ in the myocardial cells, alteration in the production ofadipokines and cytokines, reducing the extend of cardiac cells necrosis and cardiac fibrosis[1]. Urogenital infections, decrease in glomerular filtration rate, reduction in uric acid levels, postural hypotension, dizziness, bladder and breast cancer are some of the postulated adverse effects associated with SGLT2 inhibitors[3].