Influences of SGLT2 inhibitors on the cardiovascular system of patients with type 2 Diabetes mellitus: an integrative review
DOI:
https://doi.org/10.33448/rsd-v11i16.38091Keywords:
Diabetes mellitus; SGLT2i; Glycemia; Cardiovascular risk.Abstract
Introduction: Type 2 Diabetes Mellitus is a disease characterized by micro and macrovascular complications, being one of the main risk factors for the development of cardiovascular diseases. In this sense, SGLT2 inhibitors appear, drugs with potential glycemic-lowering effects, as well as influencing other aspects that directly interfere with diabetes. Thus, this review aims to elucidate the risk-benefit of the use of these drugs as well as the comparison between them regarding the advantages offered. Methodology: the present study consists of an exploratory integrative literature review. A bibliographic survey was carried out through electronic searches in the following databases: Virtual Health Library (BVS), Scientif Electronic Library Online (SciELO) and National Library of Medicine (PubMed). Results and Discussion: Several studies have shown the cardioprotective effects of SGLT2 inhibitors in patients with DM2. These studies showed that Empaglifozin, Canagliflozin and Dapaglifozin considerably reduce blood glucose and have better effects than hypoglycemic agents that use exogenous insulin or that induce endogenous insulin. In addition, they are related to decreased blood pressure, improved arterial compliance, reduced visceral adiposity, reduced serum uric acid levels and oxidative stress, as well as improved body weight. However, they also have adverse effects, especially urinary tract infection. Conclusion: despite the great effectiveness, more studies are needed, including the Brazilian population, for further elucidation about these drugs and their use as therapy by the Health System.
References
Bae, J. H., et al (2019). Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Scientific reports, 9(1), 13009.
Bonaventura, A., et al. (2019). Pharmacologic strategies to reduce cardiovascular disease in type 2 diabetes mellitus: focus on SGLT-2 inhibitors and GLP-1 receptor agonists. Journal of internal medicine, 286(1), 16–31.
De Souza, T. M., et al. (2010). Revisão integrativa: o que é e como fazer. Einstein, 8(1). https://doi.org/10.1590/S1679-45082010RW1134
Drexel, H., et al. (2019). Are SGLT2 polymorphisms linked to diabetes mellitus and cardiovascular disease? Prospective study and meta-analysis. Bioscience reports, 39(8), BSR20190299.
Ghosh, R. K., et al. (2016). Cardiovascular outcomes of sodium-glucose cotransporter 2 inhibitors: A comprehensive review of clinical and preclinical studies. International journal of cardiology, 212, 29–36.
Levine M. J. (2017). Empagliflozin for Type 2 Diabetes Mellitus: An Overview of Phase 3 Clinical Trials. Current diabetes reviews, 13(4), 405–423.
Li, C. X., et al. (2021). Cardiovascular outcomes associated with SGLT-2 inhibitors versus other glucose-lowering drugs in patients with type 2 diabetes: A real-world systematic review and meta-analysis. PloS one, 16(2), e0244689.
Qiu, M., et al. (2021). Effects of SGLT2 inhibitors on cardiovascular and renal outcomes in type 2 diabetes: A meta-analysis with trial sequential analysis. Medicine, 100(10), e25121.
Tinajero, M. G., & Malik, V. S. (2021). An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinology and metabolism clinics of North America, 50(3), 337–355.
Toyama, T., et al. (2019). Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type 2 diabetes mellitus and chronic kidney disease: A systematic review and meta-analysis. Diabetes, obesity & metabolism, 21(5), 1237–1250.
Kim, Y. G., et al. (2018). Association between sodium glucose co-transporter 2 inhibitors and a reduced risk of heart failure in patients with type 2 diabetes mellitus: a real-world nationwide population-based cohort study. Cardiovascular diabetology, 17(1), 91.
Wu, J. H., et al. (2016). Effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular events, death, and major safety outcomes in adults with type 2 diabetes: a systematic review and meta-analysis. The lancet. Diabetes & endocrinology. 4(5), 411–419.
Yu, B., et al. (2021). Effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on renal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease: A protocol for systematic review and meta-analysis. Medicine, 100(8), e24655.
Nunes, C. P., et al. (2020). Eficácia e Eventos Adversos dos Inibidores de SGLT-2. Revista da Faculdade de Medicina de Teresópolis. 4(1), 14-21.
Silva, G. A., et al. (2020). Inibidores da SGLT2 e suas influências no sistema cardiovascular: uma revisão sistemática. Electronic Journal Collection Health. Volume (Sup.44), e3325.
Bezerra, T. G., et al. (2021). Repercussões cardiovasculares do uso de inibidores de SGLT2 em portadores de Diabetes Mellitus tipo 2. Revista Eletrônica Acervo Saúde. 13(5), e6890.
Pilio, P. T. S. et al. (2021). Use of SGLT-2 inhibitors in the treatment of hart insufficiency. Brazilian Journal of Health Review. 4(2), 4111-4119.
Oliveira, R. E. S., et al. (2021). Use of SGLT-2 inhibitors in heart failure patients with reduced ejection fraction. Brazilian Journal of Health Review. 4(5), 21123-21138.
Martis, J. B., et al. (2021). Effects of GLP- 1 analogues as SGLT-1inhibitors on cardiovascular outcomes in patients with type 2 Diabetes Mellitus. Brazilian Journal of Health Review. 4(5), 21180-21192.
Vieira, I. A. G., et al. (2022). Use of SGLT2 inhibitors in heart failure: a literature review. Studies in Health Sciences. 3(2), 698-705.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Ana Laura Caldeira Souza; Artur Rosse Martins; Luciana Martins Lohmann; Karine Siqueira Cabral Rocha
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
