Hormonal
SGLT2 inhibitors (empagliflozin, canagliflozin, dapagliflozin) reduce cardiovascular mortality and heart failure hospitalization in type 2 diabetes patients, primarily through hemodynamic effects (osmotic diuresis and natriuresis) rather than glucose-lowering.
If you have Type 2 Diabetes and heart or kidney issues, SGLT2 inhibitors (like empagliflozin or dapagliflozin) are now considered a primary treatment option. They protect your heart and kidneys through fluid balance mechanisms, not just by lowering sugar. Discuss with your doctor if you are a candidate, especially if you have existing heart disease or kidney impairment.
The mechanisms by which SGLT2 inhibitors improve CV outcome appear not to be glucose-lowering or anti-atherosclerotic effects, but rather hemodynamic effects through osmotic diuresis and natriuresis.
Why this rating
Based on large-scale randomized controlled trials (EMPA-REG, CANVAS) and meta-analyses cited in the review.
Source
SGLT2 Inhibitors: The Star in the Treatment of Type 2 Diabetes?
Yoshifumi Saisho · Diseases · 2020
DOI 10.3390/diseases8020014
More from this paper
- SGLT2 inhibitors promote weight loss and improve metabolic parameters (blood pressure, lipid profile, uric acid) by increasing urinary glucose excretion, resulting in an energy deficit of 240-320 kcal/day.Good
- SGLT2 inhibitors lower HbA1c by 0.6-0.8% without increasing hypoglycemia risk when used as monotherapy, but require dose adjustment of insulin/secretagogues when combined.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
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- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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