Sodium Glucose Co-Transporter 2 Inhibitors

Sodium glucose cotransporter 2 (SGLT2) inhibitors are a novel class of medications that reduce plasma glucose concentrations through an insulin-independent mechanism of increased urinary glucose excretion. SGLT2 is a transport protein located in the S1 segment of the proximal tubule and is responsible for the reabsorption of approximately 90% of filtered glucose in the kidneys, Beneficial effects of SGLT2 inhibitors on cardiovascular risk factors such as plasma glucose and HbA1c levels, body weight, lipid profile, serum uric acid levels and hypertension are known. Mechanisms mediating their cardioprotective effects include diuretic and hemodynamic effects, improvement in myocardial metabolism, anti-inflammatory and antifibrotic effects, effects on cardiac ion channels, serum uric acid levels and kidney function. Randomized controlled clinical trials such as EMPA-REG OUTCOME, CANVAS, DECLARE’TIMI 58 and VERTIS CV have demonstrated that SGLT2 inhibitors reduced the relative risk of hospitalization for heart failure by 27-35%. Meta-analysis studies have shown that the risk of major adverse cardiovascular events is reduced by 11% with SGLT2 inhibitors. Recent guidelines state that SGLT2 inhibitors is the recommended first-line treatment in patients with high-risk or pre-existing atherosclerotic cardiovascular disease.

Recommended citation: Vidin Şen A, Alp Yıldırım Fİ. Sodyum glukoz ko-transporter 2 inhibitörleri. Kerry Z, Yağdı T, editörler. Kalp Yetersizliği ve Tedavisinde Yeni Hedefler. 1. Baskı. Ankara: Türkiye Klinikleri; 2023. p.141-6.
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