Sudhakar PemminatiCalifornia Health Sciences University College of Osteopathic Medicine, USA
Title: The effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on cardiovascular system
The increasing prevalence of metabolic diseases such as cardiovascular disease, diabetes mellitus, and the need for new pharmacological interventions have raised the importance of exploring the potential of Sodium-glucose cotransporter 2 inhibitors (SGLT2i). SGLT2i is a class of medications that target SGLT2 receptors in the kidneys, reducing glucose reabsorption. While their primary benefit is lowering glucose levels, especially in individuals with type 2 diabetes (T2DM), they exert various effects on the body. This article aims to examine how SGLT2i impacts six key organ systems, shedding light on current knowledge, potential advantages, and associated risks in clinical practice. Medications ending with the suffix "flozins" that inhibit SGLT2 have been observed to alleviate hypertension, acute cardiac failure, and bradycardia within the cardiovascular system. They have also shown promise in addressing conditions like acute pulmonary edema, asthma, bronchitis, and chronic obstructive pulmonary disease (COPD) in the pulmonary system. Notably, SGLT2 is present in the blood-brain barrier (BBB), and consequently, SGLT2i can influence the central nervous system (CNS) by reducing reactive oxygen species (ROS), BBB permeability, microglia activity, and acetylcholinesterase (AChE) levels. In the liver, this drug class has demonstrated potential in managing non-alcoholic fatty liver disease (NAFLD), hepatotoxicity, and promoting weight loss. Within the pancreas, SGLT2i has exhibited benefits primarily related to diabetes and hyperglycemia. Additionally, SGLT2i has shown promise in reducing nephrotoxicity and slowing the decline in glomerular filtration rate (GFR). Recent studies have indicated their effectiveness in individuals undergoing kidney transplants. Despite their positive effects, concerns about adverse effects associated with SGLT2i, particularly "flozin" drugs, are noteworthy. These concerns encompass urinary tract infections (UTIs), dehydration, orthostatic hypotension, postural dizziness, syncope, hypotension, hyperkalemia-induced cardiac arrest, and pancreatitis. This literature review will provide an in-depth analysis of the benefits and risks that SGLT2i poses to the cardiovascular system, with implications for their role in clinical practice.
With the growing burden of metabolic disease, cardiovascular disease, and diabetes mellitus, there is an implication for new pharmacological intervention. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a class of drugs that work on SGLT2 receptors in the kidneys to decrease glucose reabsorption. Lowering glucose levels mainly aids those with type 2 diabetes (T2DM), but they also have many other effects on the body. This article will investigate the impact of SGLT2i on six relevant organ systems; to establish current knowledge and potential benefits and risk for SGLTi in clinical practice. The medications that inhibit SGLT2 suffix with flozins are known to help decrease hypertension, acute cardiac failure, and bradycardia in the cardiovascular system. Flozins were found to aid with acute pulmonary edema, asthma, bronchitis, and chronic obstructive pulmonary disease (COPD) in the pulmonary system. SGLT2 is also found in the bloodbrain barrier (BBB), and as such, SGLT2i can also affect the central nervous system (CNS). They reduced reactive oxygen species (ROS), BBB leakage, microglia burden, and acetylcholinesterase (AChE) levels. In the liver, this class of drugs can also assist with non-alcoholic fatty liver disease (NAFLD), hepatotoxicity, and weight loss. In the pancreas, SGLT2i has been shown to help with primarily diabetes and hyperglycemia. Finally, SGLT2i's are known to aid in decreasing nephrotoxicity and stopping the progression of the glomerular filtration rate (GFR) decrease. New studies have shown that the flozin drugs have been helpful for those who were receiving kidney transplants. Despite the positive effects, there are some concerns about SGLT2i and its notable adverse effects. Flozin drugs are known to cause urinary tract infections (UTIs), dehydration, orthostatic hypotension, postural dizziness, syncope, hypotension, hyperkalemia-induced cardiac arrest, and pancreatitis. This literature review will discuss, in detail, the benefits and risks that SGTL2i have on different organ systems and implicate the role they may play in clinical practice.
To be updated soon.