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Extraglycemic Effects of SGLT2 Inhibitors: A Review of the Evidence

Authors Bonora BM, Avogaro A, Fadini GP

Received 5 October 2019

Accepted for publication 24 December 2019

Published 21 January 2020 Volume 2020:13 Pages 161—174

DOI https://doi.org/10.2147/DMSO.S233538

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Konstantinos Tziomalos


Benedetta Maria Bonora, Angelo Avogaro, Gian Paolo Fadini

Department of Medicine, University of Padova, Padova 35128, Italy

Correspondence: Gian Paolo Fadini
Department of Medicine, University of Padova, Via Giustiniani 2, Padova 35128, Italy
Tel +39 49 8214318
Fax +29 49 8212184
Email gianpaolo.fadini@unipd.it

Abstract: Patients with type 2 diabetes (T2D) are often overweight/obese and affected by arterial hypertension, dyslipidaemia, and have high serum levels of uric acid. Moreover, T2D patient have a higher risk of developing cardiovascular or renal complications, which are leading causes of morbidity and mortality in this population. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a new class of glucose-lowering medications that block the reabsorption of glucose in the kidney, thereby increasing urinary glucose excretion, and lowering blood glucose levels. The beneficial effects of SGLT2 inhibition extend beyond glycaemic control, and include improvement in blood pressure, body weight, uric acid concentrations, liver steatosis, oxidative stress, and inflammation. In dedicated cardiovascular outcome trials, SGLT2i treatment was associated with a significant reduction in the rate of cardiovascular events and renal endpoints. In this review, we summarize the evidence for extra-glycemic effects of SGLT2i and the potential mechanisms driving cardiorenal protection exerted by this class of medications.

Keywords: type 2 diabetes, sodium-glucose cotransporter-2 inhibitors, cardiovascular effects, renal effects, review

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