Breaking Barriers: How SGLT2 Inhibitors Are Redefining the Standard of Care for Type 2 Diabetes

A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM).

This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to:

• protective mechanisms capable of slowing or preventing the onset of long-term cardiovascular, renal and metabolic (CVRM) complications, making their use highly applicable for organ protection
• the maintenance of long-term health outcomes. SGLT2is have shown cost-effectiveness in T2DM management and economic savings over other glucose-lowering therapies due to:

1. reduced incidence of cardiovascular and renal events

2. National and international guidelines advocate SGLT2i use early in the T2DM management pathway, based upon a plethora of supporting data from:

• large-scale cardiovascular out? come trials,
• Renal outcomes trials and
• ?Real-world studies.

While most people with T2DM would benefit from CVRM protection through SGLT2i use, prescribing hesitancy remains, potentially due to:

·??confusion concerning their place in the complex therapeutic paradigm,

· Variation in licensed indications or

·?safety perceptions/misunderstandings associated with historical data that have since been superseded by robust clinical evidence and long-term pharmacovigilance reporting.

This latest narrative review developed by the Improving Diabetes Steering Committee (IDSC) outlines the place of SGLT2is within current evidence-informed guidelines, examines their potential as the standard of care for most newly diagnosed people with T2DM and sets into context the perceived risks and proven advantages of SGLT2is in terms of sustained health outcomes.

The authors discuss the cost-effectiveness case for SGLT2is and provide user-friendly tools to support healthcare professionals in correctly applying these medicines in T2DM management.

https://link.springer.com/article/10.1007/s13300-024-01550-5?fbclid=IwAR0EVlVif8XDVLkNLhncLOBFp5IYE4opMq1f1heyVEcR_LlwLLknO00qTvU_aem_AUdMyqFPP4Z8q5vD3BvuUzkejzr0sM2fUZtQw18k4GYjeV0oJyE8iBJtbflK5lrMBSFugFtH0btbMqodBSGL9PEG