IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i16p2965-d258585.html
   My bibliography  Save this article

SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects

Author

Listed:
  • Anastasios Tentolouris

    (Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece)

  • Panayotis Vlachakis

    (Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece)

  • Evangelia Tzeravini

    (Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece)

  • Ioanna Eleftheriadou

    (Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece)

  • Nikolaos Tentolouris

    (Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece)

Abstract

Type 2 diabetes mellitus is a chronic metabolic disease associated with high cardiovascular (CV) risk. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are the latest class of antidiabetic medication that inhibit the absorption of glucose from the proximal tubule of the kidney and hence cause glycosuria. Four SGLT2i are currently commercially available in many countries: canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT2i reduce glycated hemoglobin by 0.5%–1.0% and have shown favorable effects on body weight, blood pressure, lipid profile, arterial stiffness and endothelial function. More importantly, SGLT2i have demonstrated impressive cardioprotective and renoprotective effects. The main mechanisms underlying their cardioprotective effects have been attributed to improvement in cardiac cell metabolism, improvement in ventricular loading conditions, inhibition of the Na + /H + exchange in the myocardial cells, alteration in adipokines and cytokines production, as well as reduction of cardiac cells necrosis and cardiac fibrosis. The main adverse events of SGLT2i include urinary tract and genital infections, as well as euglycemic diabetic ketoacidosis. Concerns have also been raised about the association of SGLT2i with lower limb amputations, Fournier gangrene, risk of bone fractures, female breast cancer, male bladder cancer, orthostatic hypotension, and acute kidney injury.

Suggested Citation

  • Anastasios Tentolouris & Panayotis Vlachakis & Evangelia Tzeravini & Ioanna Eleftheriadou & Nikolaos Tentolouris, 2019. "SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects," IJERPH, MDPI, vol. 16(16), pages 1-27, August.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2965-:d:258585
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/16/2965/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/16/2965/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Auryan Szalat & Amichai Perlman & Mordechai Muszkat & Mogher Khamaisi & Zaid Abassi & Samuel N. Heyman, 2018. "Can SGLT2 Inhibitors Cause Acute Renal Failure? Plausible Role for Altered Glomerular Hemodynamics and Medullary Hypoxia," Drug Safety, Springer, vol. 41(3), pages 239-252, March.
    2. Elizabeth S Mearns & Diana M Sobieraj & C Michael White & Whitney J Saulsberry & Christine G Kohn & Yunes Doleh & Eric Zaccaro & Craig I Coleman, 2015. "Comparative Efficacy and Safety of Antidiabetic Drug Regimens Added to Metformin Monotherapy in Patients with Type 2 Diabetes: A Network Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-28, April.
    3. Heidi Storgaard & Lise L Gluud & Cathy Bennett & Magnus F Grøndahl & Mikkel B Christensen & Filip K Knop & Tina Vilsbøll, 2016. "Benefits and Harms of Sodium-Glucose Co-Transporter 2 Inhibitors in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-23, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ylenia Ingrasciotta & Maria Paola Bertuccio & Salvatore Crisafulli & Valentina Ientile & Marco Muscianisi & Luca L’Abbate & Maurizio Pastorello & Vincenzo Provenzano & Alessandro Scorsone & Salvatore , 2020. "Real World Use of Antidiabetic Drugs in the Years 2011–2017: A Population-Based Study from Southern Italy," IJERPH, MDPI, vol. 17(24), pages 1-21, December.
    2. Gareth Hopkin & Anson Au & Verena Jane Collier & John S. Yudkin & Sanjay Basu & Huseyin Naci, 2019. "Combining Multiple Treatment Comparisons with Personalized Patient Preferences: A Randomized Trial of an Interactive Platform for Statin Treatment Selection," Medical Decision Making, , vol. 39(3), pages 264-277, April.
    3. Sarah Batson & Hannah Burton, 2016. "A Systematic Review of Methods for Handling Missing Variance Data in Meta-Analyses of Interventions in Type 2 Diabetes Mellitus," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-10, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:16:p:2965-:d:258585. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.