SGLT2 Inhibitors and Diabetes: Where Does It Come from and Where Does It Go?

Abstract

Sodium glucose cotransporter 2 (SGLT2) inhibitors have emerged as powerful medications in the past decade. Numerous clinical trials have reported their cardio-renal protective effects and associated reductions in mortality. The beneficial effects of SGLT2 inhibitors in mediating heart failure and chronic kidney disease progression have been consistent across patients with and without diabetes regardless of ejection fraction. Therefore, SGLT2 inhibitors are not only antidiabetic drugs but also medications for heart failure and chronic kidney disease. However, adverse events such as genital infections and diabetic ketoacidosis should be considered. In this review, we explore the journey of SGLT2 inhibitors, often referred to as the “statins of the 21st century,” from their inception to the present day. We introduce the strengths and weaknesses of this medication and discuss unresolved issues that should be taken into considerations when prescribing SGLT2 inhibitors.