Hitting the Sweet Spot: A Review of SGLT2i in Cardiovascular Medicine.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a class of medications initially developed for glycemic control in type 2 diabetes mellitus (T2DM) but found to have broader cardiometabolic impacts. In this review, we discuss the proposed mechanisms of action of SGLT2i and review important trials that have demonstrated improvements in cardiovascular outcomes. SGLT2i have demonstrated benefits in the treatment of major categories of cardiovascular disease (CVD) and have been shown to reduce major adverse cardiovascular events (MACE) in patients with diabetes and CVD or renal disease. Findings have been translated into recommendations in clinical guidelines by the American College of Cardiology (ACC), American Heart Association (AHA), European Society of Cardiology (ESC), and American Diabetes Association (ADA). It is important to consider a patient's comorbid conditions, as well as potential medication side effects, prior to initiating SGT2i. While large trials have established the cardiovascular (CV) and renal benefits of SGLT2i, a number of studies are now exploring their role in acute care settings and novel patient populations.