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SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review

Samuel Seidu, Vicki Alabraba, Sarah Davies, Philip Newland-Jones, Kevin Fernando, Steve Bain Orcid Logo, Jane Diggle, Marc Evans, June James, Naresh Kanumilli, Nicola Milne, Adie Viljoen, David C. Wheeler, John P. H. Wilding Orcid Logo

Diabetes Therapy, Volume: 15, Issue: 5, Pages: 1099 - 1124

Swansea University Author: Steve Bain Orcid Logo

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DOI (Published version): 10.1007/s13300-024-01550-5

Abstract

A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM). This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable of slowin...

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Published in: Diabetes Therapy
ISSN: 1869-6953 1869-6961
Published: Springer Science and Business Media LLC 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa65982
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spelling v2 65982 2024-04-09 SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false 2024-04-09 MEDS A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM). This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable of slowing or preventing the onset of long-term cardiovascular, renal and metabolic (CVRM) complications, making their use highly applicable for organ protection and the maintenance of long-term health outcomes. SGLT2is have shown cost-effectiveness in T2DM management and economic savings over other glucose-lowering therapies due to reduced incidence of cardiovascular and renal events. National and international guidelines advocate SGLT2i use early in the T2DM management pathway, based upon a plethora of supporting data from large-scale cardiovascular outcome trials, renal outcomes trials and real-world studies. While most people with T2DM would benefit from CVRM protection through SGLT2i use, prescribing hesitancy remains, potentially due to confusion concerning their place in the complex therapeutic paradigm, variation in licensed indications or safety perceptions/misunderstandings associated with historical data that have since been superseded by robust clinical evidence and long-term pharmacovigilance reporting. This latest narrative review developed by the Improving Diabetes Steering Committee (IDSC) outlines the place of SGLT2is within current evidence-informed guidelines, examines their potential as the standard of care for the majority of newly diagnosed people with T2DM and sets into context the perceived risks and proven advantages of SGLT2is in terms of sustained health outcomes. The authors discuss the cost-effectiveness case for SGLT2is and provide user-friendly tools to support healthcare professionals in the correct application of these medicines in T2DM management. The previously published IDSC SGLT2i Prescribing Tool for T2DM Management has undergone updates and reformatting and is now available as a Decision Tool in an interactive pdf format as well as an abbreviated printable A4 poster/wall chart. Journal Article Diabetes Therapy 15 5 1099 1124 Springer Science and Business Media LLC 1869-6953 1869-6961 Cardiovascular, renal and metabolic protection; Oral glucose-lowering medicines; SGLT2is; Sodium-glucose cotransporter-2 inhibitors; Standard of care; Type 2 diabetes mellitus 1 5 2024 2024-05-01 10.1007/s13300-024-01550-5 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee A. Menarini Farmaceutica Internazionale SRL has fully funded the creation of this manuscript and has reviewed and certified it for technical accuracy (Dec 2023 | PP-NP-UK-0015). A. Menarini Farmaceutica Internazionale SRL also provided funding for the journal’s Rapid Service Fee. All authors had full access to all of the data discussed in the paper and take responsibility for the integrity of the information presented. 2024-05-28T15:54:26.9829902 2024-04-09T08:16:30.7642423 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science Samuel Seidu 1 Vicki Alabraba 2 Sarah Davies 3 Philip Newland-Jones 4 Kevin Fernando 5 Steve Bain 0000-0001-8519-4964 6 Jane Diggle 7 Marc Evans 8 June James 9 Naresh Kanumilli 10 Nicola Milne 11 Adie Viljoen 12 David C. Wheeler 13 John P. H. Wilding 0000-0003-2839-8404 14 65982__30214__62c8501630ff4c9aa8244a6f58bb6032.pdf 65982.pdf 2024-05-01T14:17:29.0722204 Output 3326009 application/pdf Version of Record true © The Author(s) 2024. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
spellingShingle SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
Steve Bain
title_short SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
title_full SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
title_fullStr SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
title_full_unstemmed SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
title_sort SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review
author_id_str_mv 5399f4c6e6a70f3608a084ddb938511a
author_id_fullname_str_mv 5399f4c6e6a70f3608a084ddb938511a_***_Steve Bain
author Steve Bain
author2 Samuel Seidu
Vicki Alabraba
Sarah Davies
Philip Newland-Jones
Kevin Fernando
Steve Bain
Jane Diggle
Marc Evans
June James
Naresh Kanumilli
Nicola Milne
Adie Viljoen
David C. Wheeler
John P. H. Wilding
format Journal article
container_title Diabetes Therapy
container_volume 15
container_issue 5
container_start_page 1099
publishDate 2024
institution Swansea University
issn 1869-6953
1869-6961
doi_str_mv 10.1007/s13300-024-01550-5
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
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description A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM). This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable of slowing or preventing the onset of long-term cardiovascular, renal and metabolic (CVRM) complications, making their use highly applicable for organ protection and the maintenance of long-term health outcomes. SGLT2is have shown cost-effectiveness in T2DM management and economic savings over other glucose-lowering therapies due to reduced incidence of cardiovascular and renal events. National and international guidelines advocate SGLT2i use early in the T2DM management pathway, based upon a plethora of supporting data from large-scale cardiovascular outcome trials, renal outcomes trials and real-world studies. While most people with T2DM would benefit from CVRM protection through SGLT2i use, prescribing hesitancy remains, potentially due to confusion concerning their place in the complex therapeutic paradigm, variation in licensed indications or safety perceptions/misunderstandings associated with historical data that have since been superseded by robust clinical evidence and long-term pharmacovigilance reporting. This latest narrative review developed by the Improving Diabetes Steering Committee (IDSC) outlines the place of SGLT2is within current evidence-informed guidelines, examines their potential as the standard of care for the majority of newly diagnosed people with T2DM and sets into context the perceived risks and proven advantages of SGLT2is in terms of sustained health outcomes. The authors discuss the cost-effectiveness case for SGLT2is and provide user-friendly tools to support healthcare professionals in the correct application of these medicines in T2DM management. The previously published IDSC SGLT2i Prescribing Tool for T2DM Management has undergone updates and reformatting and is now available as a Decision Tool in an interactive pdf format as well as an abbreviated printable A4 poster/wall chart.
published_date 2024-05-01T15:54:25Z
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