Chaurasia Pallavi Prakash, Dholariya Sagar, Kotadiya Fenilkumar, Bhavsar Milav
Internal Medicine, RotaCare Clinic, Walnut Creek, USA.
Biochemistry, All India Institute of Medical Sciences, Rajkot, Rajkot, IND.
Cureus. 2021 Sep 26;13(9):e18300. doi: 10.7759/cureus.18300. eCollection 2021 Sep.
Diabetes mellitus is a chronic disease that affects multiple organs and exhibits significant complications. The major outcomes of prolonged hyperglycemia are nephropathy, retinopathy, neuropathy, and cardiovascular events due to the glycation of lipids and proteins. To ensure a healthy lifestyle for diabetic patients, a treatment that delays the complications and simultaneously protects multiple organs is required. Sodium-glucose cotransporter inhibitors (SGLTi) inhibit the reabsorption of glucose from the kidney and shows promising benefits in renal and heart diseases. The major SGLT receptors are SGLT1 and SGLT2. Various trials are conducted to conclude their efficacy and show nephroprotective and cardioprotective roles independent of diabetic status. The FDA-approved SGLT2 inhibitors are empagliflozin (Jardiance®), canagliflozin (Invokana®), and dapagliflozin (Farxiga®), which are primarily used in type 2 diabetes mellitus (T2DM). They show a reduced rate of hospitalization for heart failure, cardiovascular disease mortality, all-cause mortality, and progression of diabetic kidney disease. It also shows improvement in the glycemic index; therefore, it is protective against the complications of diabetes irrespective of insulin release, thus avoids hypoglycemia. This review summarizes the data from the clinical trials that support the efficacy of SGLT2 inhibitors in reducing the risks of cardiovascular and renal outcomes in patients with T2DM.
糖尿病是一种影响多个器官并伴有严重并发症的慢性疾病。长期高血糖的主要后果是由于脂质和蛋白质糖化导致的肾病、视网膜病变、神经病变以及心血管事件。为确保糖尿病患者的健康生活方式，需要一种既能延缓并发症又能同时保护多个器官的治疗方法。钠-葡萄糖协同转运蛋白抑制剂（SGLTi）可抑制肾脏对葡萄糖的重吸收，在肾脏和心脏疾病方面显示出有前景的益处。主要的SGLT受体是SGLT1和SGLT2。已开展了各种试验来总结它们的疗效，并显示其在独立于糖尿病状态的情况下具有肾脏保护和心脏保护作用。美国食品药品监督管理局（FDA）批准的SGLT2抑制剂有恩格列净（欧唐静®）、卡格列净（怡可安®）和达格列净（安达唐®），它们主要用于2型糖尿病（T2DM）。它们显示出心力衰竭住院率、心血管疾病死亡率、全因死亡率以及糖尿病肾病进展率降低。其还显示出血糖指数改善；因此，无论胰岛素释放情况如何，它都能预防糖尿病并发症，从而避免低血糖。本综述总结了来自临床试验的数据，这些数据支持SGLT2抑制剂在降低T2DM患者心血管和肾脏结局风险方面的疗效。
