SGLT2 Inhibitors: A Modern Approach to Cardio-Renal-MetabolicProtection

Authors

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as an important therapeutic class offering significant cardio-renal-metabolic protection beyond glycaemic control in type 2 diabetes mellitus. Initially developed as glucose lowering agents, these drugs are now recognized for their beneficial effects on heart failure, chronic kidney disease, and metabolic dysfunction-associated steatotic liver disease (MASLD). By inhibiting renal glucose and sodium reabsorption in the proximal tubule, SGLT2 inhibitors promote glucosuria, natriuresis, osmotic diuresis, and restoration of tubuloglomerular feedback, leading to improved cardiovascular and renal outcomes. Clinical studies have demonstrated reductions in albuminuria, slowing of chronic kidney disease progression, and decreased hospitalization for heart failure in both diabetic and non-diabetic patients. Emerging evidence also supports their role in improving hepatic steatosis, liver enzyme abnormalities, and metabolic parameters in patients with MASLD and metabolic dysfunction-associated steatohepatitis (MASH). Their application in compensated cirrhosis and refractory ascites is increasingly being explored, although caution is necessary in advanced liver disease because of risks related to volume depletion, renal dysfunction, electrolyte disturbances, and infections. Overall, SGLT2 inhibitors represent a modern multidimensional therapeutic approach with expanding applications across cardiovascular, renal, and hepatic medicine.

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Published

2026/06/03

Issue

Vol. Volume 7-issue 2

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