SGLT2 inhibitors — heart and kidney effects
A class designed to flush glucose through the kidneys, with side benefits that may matter more than the original use case.
SGLT2 inhibitors were designed to lower blood sugar by blocking glucose reabsorption in the kidneys. The unexpected cardiovascular and renal benefits turned out to be the bigger story.
Cardiovascular protection
Dedicated trials (EMPA-REG, DAPA-HF, CANVAS) showed reduction in cardiovascular death and hospitalisation for heart failure independent of glycemic control.
Renal protection
Slows progression of diabetic kidney disease. Doses are sometimes continued in non-diabetic heart failure for the renal benefit.
Watch for
Urinary tract infections, genital mycotic infections, volume depletion, and rarely euglycemic DKA (especially during illness or fasting). Skip doses if you cannot eat normally.