A Comprehensive Review of SGLT2 Inhibitor’s Effects on Cardiovascular Events, Mortality, and Significant Safety Outcomes in Individuals with Type 2 Diabetes

SGLT2 inhibitors (SGLT2i) are a primary treatment for cardiovascular disorders, with eight major cardiovascular outcome trials (CVOTs) showing their role in reducing mortality, cardiovascular events, and renal disease. While SGLT2i exhibit diuretic activity through osmotic diuresis, side effects like hypovolemia and increased hematocrit are noted. The antihyperglycemic effects of SGLT2i diminish over time, raising concerns about long-term glycemic control in diabetic patients, particularly those with renal impairment. Interestingly, the selectivity of SGLT2 inhibition over SGLT1 influences cardiovascular outcomes; increased SGLT1 inhibition may reduce stroke risk in high-risk type 2 diabetes (T2D) patients. SGLT2i also reduce the incidence of atrial fibrillation, a stroke risk factor. Studies suggest that in high-risk T2D individuals, combined SGLT1/2 inhibition could offer a novel approach for stroke prevention. However, further research is needed to assess the broader clinical implications of these findings.