Romanian Society of Pharmaceutical Sciences
 

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NEW DIRECTIONS IN PHARMACOLOGICAL TREATMENT WITH SGLT-2 INHIBITOR MOLECULES IN THE LIGHT OF CURRENT GUIDELINES FOR DIABETES MELLITUS, HEART FAILURE AND KIDNEY DISEASE

MARIANA CORNELIA TILINCA 1,2, CSILLA ANTAL 2, ANDREEA SĂLCUDEAN 3*, BIANCA LARISA ABĂLAȘEI 4, ROXANA MARIA FĂRCAȘ 2, ALEXANDRA GROȘAN 5

1Department of Internal Medicine I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142, Romania
2 Department of Diabetology, Emergency Clinical County Hospital of Târgu Mureș, 540042, Romania
3 Department of Ethics and Social Sciences, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142, Romania
4 Department of Psychiatry II, Clinical County Hospital of Târgu Mureș, 540072, Romania
5 Department of Pharmacology and Clinical Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142, Romania

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Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a newer class of oral anti-hyperglycaemic agents, have been shown to improve cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM), by reducing the risk of heart failure, cardiovascular death, and renal events. This review aimed to describe the mechanism of action and clinical benefits of SGLT-2 inhibitors, highlighting their cardiorenal protection, glucose lowering effects, and their efficacy in the management of T2DM with multiple risk factors. SGLT-2 inhibitors reduce the reabsorption of sodium and glucose from the proximal tubules, thereby increasing renal glucose and sodium excretion. In addition to their glucose-lowering property, the clinical benefits of SGLT-2 inhibitors involve weight loss and major cardio- and reno-protective effects such as decreased preload and afterload, reversed cardiac remodelling, improved endothelial function, reduced albuminuria, improved glomerular hemodynamic and preserved kidney function. Therefore, SGLT2 inhibitors are a crucial component of management guidelines for diabetes, heart failure and chronic kidney disease, even in those without T2DM.