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Sodium-Glucose Cotransporter-2 Inhibitors: Who, When & How? Guidance for Use from a Multidisciplinary Practical Approach

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International Journal of Clinical Medicine 2024年第9期15卷 413-435页

作者： Khalifa Abdullah Magdy ElSharkawy Emad R. Issak Ahmed Shawky ElSerafy Samah Idris Ahmed Bendary Haytham Reda Badr May Shehata Ashraf Reda Internal Medicine Department Diabetes & Metabolism Unit Faculty of Medicine Alexandria University Alexandria Egypt Nephrology Department Faculty of Medicine Ain Shams University Cairo Egypt Internal Medicine Department Faculty of Medicine Ain Shams University Cairo Egypt Cardiology Department Faculty of Medicine Ain Shams University Cairo Egypt Internal Medicine and Nephrology Department Faculty of Medicine Alexandria University Alexandria Egypt Cardiology Department Faculty of Medicine Benha University Benha Egypt Internal Medicine Department Diabetes and Endocrinology Unit Faculty of Medicine Menoufia University Menoufia Egypt Product Manager Al-Esraa Pharma Cairo Egypt Cardiology Department Faculty of Medicine Menoufia University Menoufia Egypt

Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have transformed diabetes management by targeting renal glucose reabsorption. Designed initially as antidiabetic agents, their ability to lower blood glucose levels independently of insulin is well-documented. Beyond glycemic control, emerging research has unveiled their profound cardiorenal benefits. By inhibiting SGLT-2 protein, these drugs enhance glucose excretion in urine, reducing blood glucose levels. This mechanism has translated into significant cardiovascular and renal protection, establishing SGLT-2 inhibitors as pivotal in managing not only diabetes but also cardiovascular and renal diseases. Recent studies have illuminated the broader therapeutic potential of SGLT-2 inhibitors beyond diabetes. Evidence indicates their efficacy in managing heart failure, chronic kidney disease (CKD), and cardiovascular complications in individuals with or without diabetes. This expanded therapeutic landscape has catalyzed a paradigm shift in SGLT-2 inhibitor use, positioning them as key agents in the cardiorenal metabolic continuum. Moreover, their role in the secondary prevention of cardiovascular events and slowing CKD progression in T2DM patients has garnered considerable attention. This consensus-based review aims to offer practical guidance in an algorithmic approach to primary care healthcare professionals to optimize SGLT-2 inhibitors utilization and maximize their benefits. The review seeks to empower clinicians to effectively manage patients who may benefit from SGLT-2 inhibitor therapy by addressing common initiation barriers and optimizing treatment strategies. Additionally, it aims to raise awareness among primary care physicians regarding the multifaceted benefits of these medications and overcome clinical inertia in their adoption into routine clinical practice.

关键词： Sodium-Glucose Cotransporter-2 Inhibitors cardiorenal benefits Therapeutic Potential Cardiovascular Protection Primary Care Optimization

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