SGLT-2 inhibitors: A quick guide


Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, used initially in the management of diabetes mellitus, have been hailed as new breakthrough drugs in cardiology and nephrology, demonstrating benefits in the treatment of heart failure and kidney disease on top of their already established effectiveness in diabetes management. As their adoption becomes more widespread, health-care professionals look for treatment guidance. This document provides a quick overview of the basic rules governing the use of SGLT-2 inhibitors.

SGLT-2 is a protein responsible for 90% of glucose reabsorption in the kidney. The class of medications known as SGLT-2 inhibitors (also referred to as gliflozins or flozins) modulate this protein and as a result produce the main metabolic effect of inhibition of glucose reabsorption and therefore lowering of blood sugar levels.

The “Quick Guide to Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors for Glycemic Control, Renal Protection, or Cardiovascular Protection” was developed by experts from McMaster University: Dr Olivia Cook, MD, and Dr Ally P.H. Prebtani, MD (endocrinology section editor and author of the McMaster Textbook); Dr Prebtani received unrestricted financial support from AstraZeneca.

The document is endorsed by the Canadian Society of Internal Medicine.

See also
  • Expanding roles of SGLT-2 inhibitors Dr Shervin Zandi from McMaster University presents a comprehensive review of the expanding use of SGLT-2 inhibitors in the treatment of diabetes, heart failure, and chronic kidney disease.
  • COVID-19 McMaster Survival Guide The COVID-19 McMaster Survival Guide is a concise, comprehensive, and practical manual addressing a broad range of topics related to COVID-19. Updated on an ongoing basis.
  • (R)evolution of pharmacologic therapy for diabetes mellitus Dr Ally Prebtani, professor of medicine in the Division of Endocrinology and Metabolism at McMaster University, discusses the recently published meta-analysis of the use of SGLT-2 inhibitors and GLP-1 receptor agonists in diabetes.
  • Heart failure treatment: SGLT-2 inhibitors Dr Harriette Van Spall, associate professor in the Division of Cardiology at McMaster University, scientist at the Population Health Research Institute, and cardiologist at Hamilton Health Sciences, answers questions about the role of SGLT-2 inhibitors in heart failure treatment.

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