Association of SGLT2 Inhibitors with Cardiovascular and Renal Outcomes in Patients with Type 2 Diabetes Mellitus
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Keywords
Cardiovascular; Diabetes; Renal Disorders; SGLT2 Inhibitors
Abstract
the impact of Sodium-glucose cotransporter 2 (SGLT2) inhibitors on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM). A cross-sectional analysis was performed from July 2023 to January 2024, with a sample of 200 T2DM patients selected through convenience sampling. The inclusion criteria encompassed adult patients treated with SGLT2 inhibitors for a minimum of six months. Primary outcomes focused on the progression of renal disease, measured by estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), and changes in serum creatinine and major adverse cardiovascular events (MACE), comprising cardiovascular death, nonfatal myocardial infarction or nonfatal stroke. Results indicated that SGLT2 inhibitors significantly reduced the risk of MACE and renal disease progression, with adjusted odds ratios demonstrating the protective effect against these complications. The study found 10% MACE event rate and 7.5% renal progression event rate, suggesting the notable clinical benefit from SGLT2 inhibitor therapy. Subgroup analysis revealed higher incidence of MACE in older participants and those with the higher BMI, while gender differences were marginal and HbA1c levels did not significantly correlate with MACE rates. This study supported the use of SGLT2 inhibitors in T2DM management and their potential role in mitigating cardiovascular and renal complications, enhancing patient outcomes, and reducing morbidity and mortality.
References
2. Jasleen B, Vishal GK, Sameera M, Fahad M, Brendan O, Deion S, Pemminati S. Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors: Benefits Versus Risk. Cureus. 2023 Jan 18;15(1):e33939. doi: 10.7759/cureus.33939.
3. Jyotsna F, Ahmed A, Kumar K, Kaur P, Chaudhary MH, Kumar S, Khan E, Khanam B, Shah SU, Varrassi G, Khatri M, Kumar S, Kakadiya KA. Exploring the Complex Connection Between Diabetes and Cardiovascular Disease: Analyzing Approaches to Mitigate Cardiovascular Risk in Patients With Diabetes. Cureus. 2023 Aug 21;15(8):e43882. doi: 10.7759/cureus.43882.
4. Charlton A, Garzarella J, Jandeleit-Dahm KAM, Jha JC. Oxidative Stress and Inflammation in Renal and Cardiovascular Complications of Diabetes. Biology (Basel). 2020 Dec 30;10(1):18. doi: 10.3390/biology10010018.
5. Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Martín C. Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci. 2020 Aug 30;21(17):6275. doi: 10.3390/ijms21176275.
6. Regassa LD, Tola A, Ayele Y. Prevalence of Cardiovascular Disease and Associated Factors Among Type 2 Diabetes Patients in Selected Hospitals of Harari Region, Eastern Ethiopia. Front Public Health. 2021 Feb 5;8:532719. doi: 10.3389/fpubh.2020.532719.
7. Ma CX., Ma XN., Guan CH. et al. Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management. Cardiovasc Diabetol. 2022;21:74. https://doi.org/10.1186/s12933-022-01516-6
8. Santos-Jaén JM, León-Gómez A, Valls Martínez MDC, Gimeno-Arias F. The Effect of Public Healthcare Expenditure on the Reduction in Mortality Rates Caused by Unhealthy Habits among the Population. Healthcare (Basel). 2022 Nov 10;10(11):2253. doi: 10.3390/healthcare10112253.
9. Rodríguez-Gutiérrez R, Millan-Alanis JM, Barrera FJ, McCoy RG. Value of Patient-Centered Glycemic Control in Patients with Type 2 Diabetes. Curr Diab Rep. 2021 Dec 13;21(12):63. doi: 10.1007/s11892-021-01433-0.
10. Ismail-Beigi F, Moghissi E, Kosiborod M, Inzucchi SE. Shifting Paradigms in the Medical Management of Type 2 Diabetes: Reflections on Recent Cardiovascular Outcome Trials. J Gen Intern Med. 2017 Sep;32(9):1044-1051. doi: 10.1007/s11606-017-4061-7.
11. Vallon V. The mechanisms and therapeutic potential of SGLT2 inhibitors in diabetes mellitus. Annu Rev Med. 2015;66:255-70. doi: 10.1146/annurev-med-051013-110046.
12. Rabizadeh S, Nakhjavani M, Esteghamati A. Cardiovascular and Renal Benefits of SGLT2 Inhibitors: A Narrative Review. Int J Endocrinol Metab. 2019 Apr 22;17(2):e84353. doi: 10.5812/ijem.84353.
13. Kalluri SR, Bhutta TH, Hannoodee H, Al Khalili M, Theik NWY, Raji OE, Shenwai P, Shah R, Khan S. Do SGLT2 Inhibitors Improve Cardio-Renal Outcomes in Patients With Type II Diabetes Mellitus: A Systematic Review. Cureus. 2021 Sep 2;13(9):e17668. doi: 10.7759/cureus.17668.
14. Sugandh F, Chandio M, Raveena F, Kumar L, Karishma F, Khuwaja S, Memon UA, Bai K, Kashif M, Varrassi G, Khatri M, Kumar S. Advances in the Management of Diabetes Mellitus: A Focus on Personalized Medicine. Cureus. 2023 Aug 18;15(8):e43697. doi: 10.7759/cureus.43697.
15. Xiang B, Zhao X, Zhou X. Cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors in diabetic and nondiabetic patients. Cardiovasc Diabetol. 2021 Apr 7;20(1):78. doi: 10.1186/s12933-021-01266-x.
16. Kyriakos G, Quiles-Sanchez LV, Garmpi A, Farmaki P, Kyre K, Savvanis S, Antoniou VK, Memi E. SGLT2 Inhibitors and Cardiovascular Outcomes: Do they Differ or there is a Class Effect? New Insights from the EMPA-REG OUTCOME trial and the CVD-REAL Study. Curr Cardiol Rev. 2020;16(4):258-265. doi: 10.2174/1573403X15666190730094215.
17. Bonora BM, Avogaro A, Fadini GP. Extraglycemic Effects of SGLT2 Inhibitors: A Review of the Evidence. Diabetes Metab Syndr Obes. 2020 Jan 21;13:161-174. doi: 10.2147/DMSO.S233538.
18. Zhang J, Wang Y, Li L, Zhang R, Guo R, Li H, Han Q, Teng G, Liu F. Diabetic retinopathy may predict the renal outcomes of patients with diabetic nephropathy. Ren Fail. 2018 Nov;40(1):243-251. doi: 10.1080/0886022X.2018.1456453.
19. Moura FA, Berg DD, Bellavia A, Dwyer JP, Mosenzon O, Scirica BM, Wiviott SD, Bhatt DL, Raz I, Feinberg MW, Braunwald E, Morrow DA, Sabatine MS. Risk Assessment of Kidney Disease Progression and Efficacy of SGLT2 Inhibition in Patients With Type 2 Diabetes. Diabetes Care. 2023 Oct 1;46(10):1807-1815. doi: 10.2337/dc23-0492.
20. Vallon V. Renoprotective Effects of SGLT2 Inhibitors. Heart Fail Clin. 2022 Oct;18(4):539-549. doi: 10.1016/j.hfc.2022.03.005.
21. Kautzky-Willer A, Leutner M, Harreiter J. Sex differences in type 2 diabetes. Diabetologia. 2023 Jun;66(6):986-1002. doi: 10.1007/s00125-023-05891-x.
22. Raparelli V, Elharram M, Moura CS, Abrahamowicz M, Bernatsky S, Behlouli H, Pilote L. Sex Differences in Cardiovascular Effectiveness of Newer Glucose-Lowering Drugs Added to Metformin in Type 2 Diabetes Mellitus. J Am Heart Assoc. 2020 Jan 7;9(1):e012940. doi: 10.1161/JAHA.119.012940.
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