Sodium-Glucose Cotransporter 2 Inhibitors: A Scoping Review of Current Evidence, Mechanisms, and Adverse Effects
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors were initially developed as oral hypoglycemic agents for type 2 diabetes (T2D), but mounting evidence has solidified their role as practice-changing therapies for cardiovascular-kidney-metabolic (CKM) syndrome, which includes congestive heart failure (CHF) and chronic kidney disease (CKD). This review summarizes the pivotal randomized controlled trials evaluating SGLT2 inhibitors, highlighting their clinical efficacy, key mechanisms of action, and adverse effects. As indications continue to expand and more patients are prescribed SGLT2 inhibitors, hospitalists must have a thorough understanding of this important medication class.
From the paper
- Harms
The impressive benefits occurred despite only modest improvements in hemoglobin A1C (by 0.4-0.6%), leading researchers to wonder how a weak oral hypoglycemic could so effectively impact cardiorenal outcomes (and whether such a medication could be useful in patients without T2D).
- Limitation
Although the aforementioned RCTs were undoubtedly rigorous, including more than 70,000 patients and contributing to a modern revolution in the treatment of CKM syndrome, several important limitations remain.
Quoted word for word from the full text on bhm.scholasticahq.com.
- SGLT2 inhibitors
- SLC5A2
- Cardiovascular-kidney-metabolic syndrome
- Chronic kidney disease
- Congestive heart failure
- Humans
The paper
Maine Medical Center
Journal of Brown Hospital Medicine, 1 Oct 2026, Open access
