SGLT2-inhibitor and its place in Contemporary Diabetes Management

The therapeutic approach for patients with type 2 diabetes is evolving rapidly. The recent published cardiovascular outcomes trials (EMPA-Reg, Canvas and DECLARE-TIMI 58), and DAPA-HF and CREDENCE studies demonstrated the benefits of Sodium-glucose transporter 2 inhibitors (SGLT2i) in improving the outcomes of diabetic patients with cardiovascular disease, heart failure and diabetic nephropathy. The cardiorenal benefits are seen beyond the glycaemic control. The treatment algorithm recommends early use of SGLT2i, especially among those with existing cardiovascular disease, heart failure or kidney disease. The side effects of SGLT2i are related to its underlying mechanisms of action, i.e. a higher incidence of genital yeast infections and urinary tract infections. SGLT2i can also cause euglycaemic ketoacidosis and is not currently indicated for use in patients with type 1 diabetes.