SGLT2 inhibitors

• sodium-glucose co-transporter inhibitors:

  • SGLT2 inhibitors not only improve glycaemic control (lowered blood glucose levels) but also reduce the development, severity and hospitalisation rate of those living with chronic heart failure
  • Intriguingly clinical researchers also noted that the use of these drugs in individuals with chronic heart failure but without a definite diagnosis of diabetes mellitus type 2 also benefitted enormously in terms of the rate of development / severity of chronic heart failure, incidence of hospitalisations and indeed prematurity of death
• • Much debate remains regarding the mechanisms by which SLGT2 inhibitors benefit those with CHF
  • At present there is still much detail to discover but top thoughts at the moment include:
  • Increased glucose excretion, promotes increased osmosis which off-loads fluid from the system i.e. acts as a diuretic
  • Enhanced glucose excretion lowers blood glucose levels (even in the non-diabetic) reducing activation of the SNS and RAAS resulting in a reduced blood pressure – off-loading the failing left ventricle
  • SGLT2 inhibitors may improve functionality at cardiomyocyte level aiding economical increases in force generation and therefore EF and cardiac out-put.