Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that suppress renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemi...

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Main Authors: Katsiki, N, Mikhailidis, D, Theodorakis, M
Format: Journal article
Published: Bentham Science Publishers 2017
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author Katsiki, N
Mikhailidis, D
Theodorakis, M
author_facet Katsiki, N
Mikhailidis, D
Theodorakis, M
author_sort Katsiki, N
collection OXFORD
description Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that suppress renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin.<br/> The present narrative review addresses the impact of SGLT2i on several cardiovascular (CV) risk factors, including fasting and postprandial plasma glucose levels, lipids, blood pressure, body weight, serum uric acid and arterial stiffness. These drugs may also favorably modulate cardiac and renal function via their effects on inflammation, oxidative stress, diuresis, fluid and sodium retention, myocardial function, vascular resistance and ‘fuel’ metabolism. In the EMPA-REG OUTCOME study, the first published large CV outcome SGLT2i trial, empagliflozin significantly reduced the primary composite outcome (i.e. CV death, nonfatal myocardial infarction or stroke) and all-cause death as well as hospitalization for heart failure. In addition, empagliflozin was associated with a slower progression of kidney disease and lower rates of clinically relevant renal events than was placebo when added to standard care in patients at high CV risk. Ongoing CV outcome trials involving other SGLT2i will help establish whether the reported CV and microvascular risk benefits are compound-specific or drug class effects.
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spelling oxford-uuid:88e0bf4a-55b2-49dd-98f8-1f196fdabcc12022-03-26T22:20:36ZSodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk managementJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:88e0bf4a-55b2-49dd-98f8-1f196fdabcc1Symplectic Elements at OxfordBentham Science Publishers2017Katsiki, NMikhailidis, DTheodorakis, MSodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that suppress renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin.<br/> The present narrative review addresses the impact of SGLT2i on several cardiovascular (CV) risk factors, including fasting and postprandial plasma glucose levels, lipids, blood pressure, body weight, serum uric acid and arterial stiffness. These drugs may also favorably modulate cardiac and renal function via their effects on inflammation, oxidative stress, diuresis, fluid and sodium retention, myocardial function, vascular resistance and ‘fuel’ metabolism. In the EMPA-REG OUTCOME study, the first published large CV outcome SGLT2i trial, empagliflozin significantly reduced the primary composite outcome (i.e. CV death, nonfatal myocardial infarction or stroke) and all-cause death as well as hospitalization for heart failure. In addition, empagliflozin was associated with a slower progression of kidney disease and lower rates of clinically relevant renal events than was placebo when added to standard care in patients at high CV risk. Ongoing CV outcome trials involving other SGLT2i will help establish whether the reported CV and microvascular risk benefits are compound-specific or drug class effects.
spellingShingle Katsiki, N
Mikhailidis, D
Theodorakis, M
Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title_full Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title_fullStr Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title_full_unstemmed Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title_short Sodium-glucose cotransporter 2 inhibitors (SGLT2i): their role in cardiometabolic risk management
title_sort sodium glucose cotransporter 2 inhibitors sglt2i their role in cardiometabolic risk management
work_keys_str_mv AT katsikin sodiumglucosecotransporter2inhibitorssglt2itheirroleincardiometabolicriskmanagement
AT mikhailidisd sodiumglucosecotransporter2inhibitorssglt2itheirroleincardiometabolicriskmanagement
AT theodorakism sodiumglucosecotransporter2inhibitorssglt2itheirroleincardiometabolicriskmanagement