A novel class of medications known as sodium-glucose cotransporter 2 (SGLT2) inhibitors holds promise for blood sugar control and total cardiorenal protection. Few discoveries have demonstrated the same potential as SGLT2 inhibitors in terms of medical improvements.
In this article, Dr. William Kristanto from Cardiac Care Partners shares his insights on how this class of drugs is transforming the management of cardiovascular and renal health.
SGLT2 inhibitors work by encouraging the elimination of extra glucose in the urine. In addition to helping patients attain reasonable blood sugar control, this unique mechanism lowers their risk of heart failure and kidney issues.
In contrast to previous diabetes treatments that raise insulin secretion to regulate blood sugar and frequently result in hypoglycaemia and weight gain, SGLT2 inhibitors provide a more all-encompassing method of treating diabetes and its associated problems.
Historically, Metformin was used as the mainstay medication for treating type 2 diabetes, with doctors prescribing the drug to patients with the primary goal of lowering their HbA1c levels to prevent the risk of devastating complications. However, more doctors are moving beyond HbA1c-focused treatment (focusing only on regulating blood glucose levels) to actively trying to prevent cardiorenal complications in patients with type 2 diabetes.
Numerous clinical trials have validated the effectiveness of SGLT2 inhibitors, including dapagliflozin, in decreasing hospitalisation rates for heart failure and enhancing cardiovascular outcomes. According to the DAPA-HF and DELIVER studies, dapagliflozin reduces the risk of cardiovascular death and deteriorating heart failure in individuals with both reduced and preserved ejection fraction heart failure.
Since then, major cardiology associations have revised their guidelines in light of the compelling data that has emerged. The American College of Cardiology and the European Society of Cardiology recommend the early usage of SGLT2 inhibitors in heart failure patients, whether a patient has diabetes. SGLT2 inhibitors are also advised for individuals with type 2 diabetes and atherosclerotic cardiovascular disease to lower the likelihood of cardiovascular events, regardless of the patient’s initial HbA1c level.
These revised guidelines reflect the use of SGLT2 inhibitors for glucose control and as an essential component of comprehensive cardiovascular risk management.
However, Dr. Kristanto cautions that patients with diabetes and heart failure still have a residual risk of cardiovascular problems despite modern advances in medications and treatments. Even if patients believe their disease has been well-controlled, Dr. Kristanto emphasised the significance of following the recommended drug routine due to underlying dangers that persist. SGLT2 inhibitors aid by providing protection that goes beyond glycaemic management, and specifically targeting the cardiovascular system.
The use of SGLT2 inhibitors has brought about a radical new way to treat complicated diseases, including heart failure and diabetes. Through the management of blood sugar regulation and cardiovascular health, these drugs provide physicians with a thorough approach to reducing risks in these susceptible patient populations. The use of SGLT2 inhibitors is expected to grow as clinical recommendations continue to change, providing patients with hope for improved health and quality of life.
