SGLT2-inhibition and Vascular Euphoria a Reconciliation of Vascular Health and Disease Homeostasis.

Mangesh Tiwaskar, Sanjay Kalra, Ganapathi Bantwal, Arpandev Bhattacharya, Manisha Sahay, Uday Jadhav, Ameya Joshi, A K Das, Dinesh Khullar, Manash Baruah, Hitesh Punyani, Kamal Kishor, Kimi Shetty, Jignesh Ved

Journal: The Journal of the Association of Physicians of India 2021;69(4):11-12

PMID: 34470191

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Abstract

The concept of SGLT2-inhibition, once regarded as a non-physiological approach to glycemia control, now finds a foundational relevance in risk-modification for cardiovascular, kidney, and metabolic outcomes, spanning beyond type-2 diabetes. Major studies have proven meaningful improvements in various clinical outcomes, with different SGLT2-i agents. Apart from glycosuria, SGLT2-inhibition is associated with several patho-physiological effects, which may contribute to the clinical benefits seen with these agents. This narrative review is an attempt to appraise the different patho-physiological effects mediated by SGLT2-inhibition, based on contemporary evidence. The review classifies these effects in the acronym of EUPHORIA, and grades the possible relevance of each effect, in improving clinical outcomes.

Address: Consultant Physician & Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra.; Consultant Endocrinologist, Bharti Hospital, Haryana.; Professor and Head of the Department of Endocrinology, St. Johns Medical College & Hospital, Bengaluru, Karnataka.; Consultant Endocrinologist, Manipal Hospital, Bengaluru, Karnataka.; Professor and Head of Nephrology Department, Osmania General Hospital, Hyderabad, Telangana.; Consultant Cardiologist, MGM Hospital, Navi Mumbai, Maharashtra.; Consultant Endocrinologist, Bhaktivedanta Hospital and Research Institute, Mumbai, Maharashtra.; Professor and Head of Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry.; Chairman - Nephrology and Renal Transplant Medicine, Department of Nephrology and Renal transplant medicine, Max Super Speciality Hospital, New Delhi.; Consultant Endocrinologist, Excel care Hospitals, Guwahati, Assam.; Consultant Diabetologist, Apollo Cradle Hospital, New Delhi.; Consultant Cardiologist, RAMA Superspeciality and Critical Care Hospital, Karnal, Haryana.; Department of Medical Affairs, Boehringer Ingelheim.

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https://medlineplus.gov/diabetestype2.html

MeSH Terms: Cardiovascular Diseases, Diabetes Mellitus, Type 2, Euphoria, Homeostasis, Humans, Hypoglycemic Agents, Sodium-Glucose Transporter 2, Sodium-Glucose Transporter 2 Inhibitors