Main Article Content

Sania Saleem
Mohammad Eyan Khan
Unaiza Nasir
Asma Rasool Peerzada
Muhammad Usman Babar
Faizan Banaras


SGLT-2 inhibitors, Gliflozins, cardiorenal outcomes, diabetes, cardiovascular health, chronic kidney disease, literature review, prospective cohort study, therapeutic options.


Background: Sodium-glucose co-transporter 2 inhibitors (SGLT-2 inhibitors or Gliflozins) have emerged as a class of drugs with potential benefits in both diabetic and non-diabetic patients. The impression of those agents on cardiorenal results in individuals with and without diabetes has been a subject of increasing interest and research. This study aims to explore and compare impacts of SGLT-2 inhibitors on cardiorenal health in these two distinct patient populations.

Aim: The main goal of our research is to explore cardiorenal outcomes in individuals having diabetes who are treated with SGLT-2 inhibitors, also in non-diabetic individuals who are prescribed these medications. The secondary aim is to discern potential differences in the mechanisms of action and therapeutic responses between diabetic and non-diabetic cohorts.

Method: A comprehensive literature review was conducted at Nephrology division Khyber Teaching Hospital (KTH) Peshawar from April 2022 to march 2023 in order to get existing research on SGLT-2 inhibitors and their impact on cardiorenal health. In addition, a prospective cohort study was carried out, including patients with and without diabetes, who were prescribed SGLT-2 inhibitors. Clinical, biochemical, and imaging data were collected, and cardiorenal endpoints such as cardiovascular events, kidney function, and quality of life were assessed. Statistical studies were achieved to compare outcomes between diabetic and non-diabetic groups.

Results: Subgroup studies were performed to investigate whether impact of SGLT-2 inhibitors on cardiorenal outcomes varied based on specific patient characteristics such as age, gender, and baseline eGFR. The research involved the overall 200 respondents, divided into two sets: these having diabetes (n=100) and those without diabetes (n=100).

Conclusion: SGLT-2 inhibitors, commonly known as Gliflozins, have shown promising results in improving cardiorenal results in both diabetic and non-diabetic patients. Their use should be considered as a therapeutic option beyond diabetes management, especially in patients at danger of cardiovascular and renal problems. Additional research is required to clarify precise mechanisms responsible for these effects and to optimize treatment strategies.


Keywords: ,, ,, , , , , 

Abstract 103 | PDF Downloads 46


1. Koufakis, T., Tsimihodimos, V., Metallidis, S., Kotsa, K., & Doumas, M. (2023). The effects of sodium-glucose cotransporter 2 inhibitors beyond the cardio-renal-metabolic spectrum: Will gliflozins have a different fate than statins?. Expert Opinion on Pharmacotherapy, 1-4.
2. Kalay, Z., Sahin, O. E., Copur, S., Danacı, S., Ortiz, A., Yau, K., ... & Kanbay, M. (2023). SGLT-2 inhibitors in nephrotic-range proteinuria: emerging clinical evidence. Clinical Kidney Journal, 16(1), 52-60.
3. Shami, D., Sousou, J. M., Batarseh, E., Alazrai, L., Batarseh, E., & Alazrai, L. I. (2023). The Roles of Glucagon-Like Peptide 1 (GLP-1) Receptor Agonists and Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors in Decreasing the Occurrence of Adverse Cardiorenal Events in Patients With Type 2 Diabetes. Cureus, 15(1).
4. Bendotti, G., Montefusco, L., Pastore, I., Lazzaroni, E., Lunati, M. E., & Fiorina, P. (2023). The anti-inflammatory and immunological properties of SGLT-2 inhibitors. Journal of Endocrinological Investigation, 1-8.
5. Collins, T. R. (2023). JAK2-Unmutated Erythrocytosis From Gliflozins Appears Benign.
6. John, S. M., Fulwood, M., & Ford, K. (2023). Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium Glucose Cotransporter-2 Inhibitors on Renal and Cardiovascular Outcomes. ADCES in Practice, 2633559X231202491.
7. Sanz, R. L., Inserra, F., García Menéndez, S., Mazzei, L., Ferder, L., & Manucha, W. (2023). Metabolic syndrome and cardiac remodeling due to mitochondrial oxidative stress involving gliflozins and sirtuins. Current Hypertension Reports, 1-16.
8. Liberale, L., Kraler, S., Puspitasari, Y. M., Bonetti, N. R., Akhmedov, A., Ministrini, S., ... & Camici, G. G. (2023). SGLT-2 inhibition by empagliflozin has no effect on experimental arterial thrombosis in a murine model of low-grade inflammation. Cardiovascular Research, 119(3), 843-856.
9. Frąk, W., Hajdys, J., Radzioch, E., Szlagor, M., Młynarska, E., Rysz, J., & Franczyk, B. (2023). Cardiovascular Diseases: Therapeutic Potential of SGLT-2 Inhibitors. Biomedicines, 11(7), 2085.
10. Scheen, A. J. (2023). The current role of SGLT2 inhibitors in type 2 diabetes and beyond: a narrative review. Expert Review of Endocrinology & Metabolism, 1-12.
11. Munoz Pena, J. M., & Cusi, K. (2023). Post-Transplant Diabetes Mellitus: Recent Developments in Pharmacological Management of Hyperglycemia. The Journal of Clinical Endocrinology & Metabolism, dgad395.
12. Ma, C., Li, X., Li, W., Li, Y., Shui, F., & Zhu, P. (2023). The efficacy and safety of SGLT2 inhibitors in patients with non-diabetic chronic kidney disease: a systematic review and meta-analysis. International Urology and Nephrology, 1-8.
13. Koya, D., Anker, S. D., Ruilope, L. M., Rossing, P., Liu, Z., Lee, B. W., ... & Pitt, B. (2023). Cardiorenal Outcomes with Finerenone in Asian Patients with Chronic Kidney Disease and Type 2 Diabetes: A FIDELIO-DKD post hoc Analysis. American Journal of Nephrology, 1-9.
14. Wang, X., Zhang, X., Zhang, W., Li, J., Weng, W., & Li, Q. (2023). Association of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) with Cardiac Arrhythmias: A Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials. Reviews in Cardiovascular Medicine, 24(9), 258.
15. Tanriover, C., Ucku, D., Akyol, M., Cevik, E., Kanbay, A., Sridhar, V. S., ... & Kanbay, M. (2023). Potential use of SGLT-2 inhibitors in obstructive sleep apnea: a new treatment on the horizon. Sleep and Breathing, 27(1), 77-89.
16. Sim, R., Chong, C. W., Loganadan, N. K., Adam, N. L., Hussein, Z., & Lee, S. W. H. (2023). Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors and dipeptidyl peptidase-4 inhibitors on cardiorenal function and treatment adherence: a prevalent new-user design study in tertiary hospitals. RPS Pharmacy and Pharmacology Reports, 2(3), rqad023.
17. Maktouf, Z. H. (2023). Treatment of DM and Empagliflozin (Doctoral dissertation, Al-Qadisiyah University).
18. Cao, H., Rao, X., Jia, J., Yan, T., & Li, D. (2023). Effects of sodium-glucose co-transporter-2 inhibitors on kidney, cardiovascular, and safety outcomes in patients with advanced chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetologica, 60(3), 325-335.
19. Hasan, M. T., Awad, A. K., Shih, M., Attia, A. N., Aboeldahab, H., Bendary, M., & Bendary, A. (2023). Meta-Analysis on the Safety and Efficacy of Sodium Glucose Cotransporters 2 Inhibitors in Patients With Heart Failure With and Without Diabetes. The American Journal of Cardiology, 187, 93-99.
20. Singh, A. P., Kalil, R. S., & Weir, M. R. (2023). Role of Sodium-Glucose Cotransporter 2 Inhibitors for Management of Diabetes Mellitus in Renal Transplant Recipients and Management Strategies for Posttransplant Hypertension. American Journal of Nephrology, 1-9.
21. Song, J., Li, X., & Ni, J. (2023). A role for sodium-glucose cotransporter 2 inhibitors in the treatment of chronic kidney disease-A mini review. Kidney & Blood Pressure Research.
22. Chen, X., Hocher, C. F., Shen, L., Krämer, B. K., & Hocher, B. (2023). Reno-and cardioprotective molecular mechanisms of SGLT2 inhibitors beyond glycemic control: from bedside to bench. American Journal of Physiology-Cell Physiology, 325(3), C661-C681.
23. Akiyama, H., Nishimura, A., Morita, N., & Yajima, T. (2023). Evolution of sodium-glucose co-transporter 2 inhibitors from a glucose-lowering drug to a pivotal therapeutic agent for cardio-renal-metabolic syndrome. Frontiers in Endocrinology, 14, 1111984.
24. Hoehlschen, J., Hofreither, D., Tomin, T., & Birner-Gruenberger, R. (2023). Redox-driven cardioprotective effects of sodium-glucose co-transporter-2 inhibitors: comparative review. Cardiovascular Diabetology, 22(1), 1-10.
25. Tokarek, J., Budny, E., Saar, M., Stańczak, K., Wojtanowska, E., Młynarska, E., ... & Franczyk, B. (2023). Molecular Processes Involved in the Shared Pathways between Cardiovascular Diseases and Diabetes. Biomedicines, 11(10), 2611.

Most read articles by the same author(s)