Integrating Sglt-2 Inhibitors into the Clinical Management of Type 2 Diabetes Mellitus and Chronic Kidney Disease: Current Evidence and Future Outlook
Agus Layanto *
Faculty of Medicine, Dian Nuswantoro University, Semarang, Indonesia.
Lely Kusumaningrum
Faculty of Medicine, Dian Nuswantoro University, Semarang, Indonesia.
Cynthia Arsita
Faculty of Medicine, Dian Nuswantoro University, Semarang, Indonesia.
Fenny Halim
Faculty of Medicine, Dian Nuswantoro University, Semarang, Indonesia.
*Author to whom correspondence should be addressed.
Abstract
Objective and Background: The prevalence of type 2 diabetes mellitus (T2DM) is steadily increasing globally. A significant complication of T2DM is diabetic kidney disease, which contributes to increased morbidity and mortality. Sodium-Glucose Co-Transporter-2 (SGLT-2) inhibitors are a class of oral antidiabetic agents that effectively lower blood glucose levels and provide protective benefits for kidney health.
Methods: A comprehensive review of studies was conducted focusing on the use of SGLT-2 inhibitors in patients with T2DM, including those with chronic kidney disease (CKD), defined as a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m², or urine albumin/creatinine ratio ≥ 30 mg alb/g creatinine. The studies evaluated clinical outcomes such as cardiovascular events, kidney disease progression, and mortality.
Results: Research findings demonstrate that SGLT-2 inhibitors significantly reduce the risk of hospitalization due to heart failure, myocardial infarction, and stroke. Additionally, these medications lower the incidence of cardiovascular-related and all-cause mortality. Renal-specific benefits include slowing the progression of albuminuria, reducing the decline in GFR, lowering the need for renal replacement therapy, and decreasing kidney-related deaths.
Keywords: Sodium-Glucose Co-Transporter-2 (SGLT-2) inhibitors, type 2 diabetes, chronic kidney disease