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Sglt2 Inhibitor: An Antidiabetic, Cardioenhancer, Renoprotector…or the Internist's Elixir? Revisão Narrativa - Uma narrativa baseada na história e na prova

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Detalhes bibliográficos
Resumo:This review article addresses the history, underlying evidence, proposed mechanisms, and clinical implication ofsodium glucose cotransporter type 2 inhibitors (SGLT2i),framing them from the perspective of the general practitioner internist of the present decade. The sodium glucose cotransporter inhibitors, onceidentified in the apple tree root bark but with no obvioustherapeutic purpose, were initially developed as another hypoglycemic agent. Recently, its use has undergone a reversal. Large randomized controlled clinical trials revealed: first drug class to improve cardiovascular outcomes and mortality in type 2 diabetes; one more prognosis-modifying class in heart failure; first class with clear benefit in prognosis and even mortality in chronic kidney disease. The mechanisms are still not completely understood, but hypotheses include a diuretic effect and metabolism modulation. Internal Medicine, as a differentiating generalist specialty,is par excellence able to deal with the all spectrum use of SGLT2i.
Autores principais:Vidal Pimentel, Bernardo
Outros Autores:Novais de Carvalho, Vanessa; Maia das Neves, Nuno; Soares Laranjeira, Francisco; Morais Sarmento, Pedro
Assunto:Diabetes Mellitus Tipo 2/tratamento farmacológico Doença renal crónica Inibidores dos Co-Transportadores de Sódio e Glucose Insuficiência Cardíaca/ tratamento farmacológico Medicina Interna Diabetes Mellitus, Type 2/drug therapy Heart Failure/drug therapy Internal Medicine Renal Insufficiency, Chronic/drug therapy Sodium-Glucose Transporter 2 Inhibitors/ therapeutic use
Ano:2024
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna
Descrição
Resumo:This review article addresses the history, underlying evidence, proposed mechanisms, and clinical implication ofsodium glucose cotransporter type 2 inhibitors (SGLT2i),framing them from the perspective of the general practitioner internist of the present decade. The sodium glucose cotransporter inhibitors, onceidentified in the apple tree root bark but with no obvioustherapeutic purpose, were initially developed as another hypoglycemic agent. Recently, its use has undergone a reversal. Large randomized controlled clinical trials revealed: first drug class to improve cardiovascular outcomes and mortality in type 2 diabetes; one more prognosis-modifying class in heart failure; first class with clear benefit in prognosis and even mortality in chronic kidney disease. The mechanisms are still not completely understood, but hypotheses include a diuretic effect and metabolism modulation. Internal Medicine, as a differentiating generalist specialty,is par excellence able to deal with the all spectrum use of SGLT2i.