SGLT2 Inhibitors and Mechanism of Cardiovascular Benefits in Type 2 Diabetes

Sodium-glucose co-transporter 2 inhibitors (SGLT2i), originally developed to lower blood glucose in type 2 diabetes (T2D) patients, have shown potential benefits in treating cardiovascular disorders, including heart failure (HF). By reducing blood glucose through renal excretion, SGLT2i also support cardiovascular health through various mechanisms like hemodynamic effects, anti-inflammatory, anti-fibrotic, antioxidant, and metabolic actions. Studies indicate that SGLT2i improve diastolic function in HF, particularly when ejection fraction is preserved, while having mixed effects on systolic function. Notably, drugs such as bexagliflozin, empagliflozin, canagliflozin, and dapagliflozin reduce HF risk in diabetic patients, with bexagliflozin showing prominent benefits. SGLT2i have demonstrated cardiovascular benefits across several clinical trials, revealing promising results for both diabetic and non-diabetic individuals. Further research is needed to enhance the understanding of SGLT2i’s cardiovascular impacts across diverse patient profiles.