Early use of SGLT2-inhibitors i in the treatment of type 2 diabetes mellitus

Czech version

Authors: Ingrid Dravecká
Authors‘ workplace: I. interná klinika LF UPJŠ a UNLP v Košiciach
Published in: Diab Obez 2024; 24(1): 7-12
Category: Reviews

Overview

Type 2 diabetes mellitus is associated with an increased risk of cardiovascular disease and mortality due to the chronic complications developed. Patients are at risk not only for the consequences of atherosclerotic cardiovascular disease, heart failure independent of coronary heart disease but also for kidney damage. Adjustment of hyperglycemia alone does not reduce cardiovascular risk. Antidiabetic treatment should not only be cardiovascularly safe but should also reduce cardiovascular risk. Sodium-glucose transporter 2 inhibitors (SGLT2i) have been shown to reduce cardiovascular mortality, the incidence of heart failure and delay/slow renal disease, independent of glucose-lowering effect, even in patients with and without confirmed cardiovascular risk and therefore may be an appropriate choice in the early management of cardiovascular disease in patients with diabetes mellitus 2. Early use of SGLT2i in the management of type 2 diabetes mellitus.

Keywords:

antidiabetic treatment– cardiovascular disease (CVD) – chronical kidney disease (CKD) – diabetes mellitus type 2 – sodium-glucose cotransporter 2 inhibitors (SGLT2i)

Sources

Fontes-Carvalho R, Santos-Ferreira D, Raz I et al. Protective effects of SGLT-2 inhibitors across the cardiorenal continuum: two faces of the same coin. Eur J Prev Cardiol 2022; 29(9): 1352–1360. Dostupné z DOI: <http://dx.doi.org/10.1093/eurjpc/zwab034>.

Wahinya M, Khan Z. Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitor Therapy for the Primary and Secondary Prevention of Heart Failure in Patients With and Without Type 2 Diabetes Mellitus: A Systematic Review. Cureus 2023; 15(4): e37388. Dostupné z DOI: <http://dx.doi.org/10.7759/cureus.37388>.

Berg DD, Wiviott SD, Scirica BM et al. Heart failure risk stratification and efficacy of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes mellitus. Circulation 2019; 140(19): 1569–1577. Dostupné z DOI: Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.119.042685>.

McMurray JJV, Wheeler DC, Stefánsson BV et al. [DAPA-CKD Trial Committees and Investigators]. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure. JACC Heart Fail 2021; 9(11): 807–820. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jchf.2021.06.017>.

Ronco C, McCullough PA, Anker SD et al. Cardiorenal syndromes: an executive summary from the consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2010; 165: 54–67. Dostupné z DOI: <http://dx.doi.org/10.1159/000313745>.

Marx N, Federici M, Schütt K et al. [ESC Scientific Document Group]. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023; 44(39): 4043–4140. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehad192>.

Kaze AD, Zhuo M, Kim SC et al. Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis. Cardiovasc Diabetol 2022; 21(1): 47. Dostupné z DOI: <http://dx.doi.org/10.1186/s12933–022–01476-x>.

Packer M, Anker SD, Butler J et al. Influence of neprilysin inhibition on the efficacy and safety of empagliflozin in patients with chronic heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial. Eur Heart J 2021; 42(6): 671–680. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehaa968>.

Toyama T, Neuen BL, Jun M et al. Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type 2 diabetes mellitus and chronic kidney disease: a systematic review and meta-analysis. Diabetes Obes Metab 2019; 21(5): 1237–1250. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13648>.

Mosenzon O, Raz I, Wiviott SD et al. Dapagliflozin and Prevention of Kidney Disease Among Patients With Type 2 Diabetes: Post Hoc Analyses From the DECLARE-TIMI 58 Trial. Diabetes Care 2022; 45(10): 2350–2359. Dostupné z DOI: <http://dx.doi.org/10.2337/dc22–0382>.

Kam-Tao Li P, Garcia-Garcia G, Lui SF et al. Health for Everyone Everywhere, from Prevention to Detection and Equitable Access to Care. Iran J Kidney Dis 2020; 14(2): 69–80.

Fox CS, Matsushita K, Woodward M et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet 2012; 380(9854): 1662–1673. Dostupné z DOI: <https://doi.org/10.1016/S0140–6736(12)61350–6>.

Brownrigg JR, Hughes CO, Burleigh D et al. Microvascular disease and risk of cardiovascular events among individuals with type 2 diabetes: a population-level cohort study. Lancet Diabetes Endocrinol 2016; 4(7): 588–597. Dostupné z DOI: <https://doi.org/10.1016/S2213–8587(16)30057–2>.

[Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group]. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int 2022; 102(Suppl 5): S1–S127. Dostupné z DOI: <https://doi.org/10.1016/j.kint.2022.06.008>.