SGLT-2 inhibitor; oral glucosuric agent; flozin
Indications
- diabetes mellitus type 2
- may be more effective as 2nd line agent than sulfonylureas or DPP-4 inhibitors[42]
- may reduce incidence of new-onset type 2 diabetes among persons with cardiovascular disease or kidney disease[50]
- heart failure[38]
- may help with weight reduction
- may lower risk for gout & gout flares in patients with type 2 diabetes[15]
- renoprotective[10][16]; slow progression of diabetic nephropathy
- may slightly lower blood pressure in diabetic patients with hypertension
- average reduction in systolic BP/diastolic BP is 5/3 mm Hg
- effect slightly greater in patients with resistant hypertension
- average reduction in systolic BP/diastolic BP is 5/3 mm Hg
* flozins lowest in cardiovascular mortality < GLP-1 agonists < DPP-4 inhibitors (no mention of metformin)[6][19]
* cardiovascular risk reduction[10][11]
- benefits greatest in patients with pre-existing CV disease
- benefit for hospitalization with heart failure[10]
- benefit in patients with chronic kidney disease[47]
- lower risk of recurrent ischemic stroke[46]
* may lower risks for heart failure, all-cause death, major cardiovascular events, & cardiovascular death[14] independent of diabetes status[18] or renal function[43]
* benefit for heart failure & cardiovascular death across cardiometabolic spectrum[44]
* no significant effect on myocardial infarction in the general population[43]
* may improve maximal exercise capacity & quality of life in patients with heart failure HFrEF or HFpEF[38]
* use as 1st line rather than metformin may reduce risk of hospitalization for heart failure, but not myocardial infarction, stroke, or all-cause mortality[25]
* dapagliflozin 10 mg QD reduces hospitalization (all cause) & death in patients with chronic kidney disease with & without type 2 diabetes (RR ~0.8)[27]
* only canagliflozin & empagliflozin may lower cardiovascular risk; dapagliflozin & ertugliflozin may not[25]
* flozins appear safe in elderly >= 75 years of age[29]
* cardiovascular benefits persist across full spectrum of glycemic control HbA1c <7.5% to > 9%[30]
* in patients with diabetes mellitus type-2, benefits for cardiovascular risk & chronic kidney disease remain regardless of GLP-1 receptor agonist use[48]
* efficacy, safety & tolerability same in elderly > 70 years vs younger patients[37]
Contraindications
- diabetes mellitus type 1 (not FDA-approved)
- renal impairment: GFR < 30 ml/min/1.73 m2[3]; maybe not*[39]
- endstage renal disease
* flozins on list of drugs to avoid[5]
* flozins are associated with a lower risk for dialysis, cardiovascular events, diabetic ketoacidosis, & acute kidney injury in patients with type 2 diabetes & stage 5 chronic kidney disease[39]
Dosage
- stop flozin 3 days prior to surgery
Adverse effects
- hypotension[3], orthostatic hypotension[37]
- SGLT-2 inhibitors have little effect on blood pressure & may be used at any time during hospitalization for acute heart failure[45]
- ketoacidosis (RR=2][1][9][17], class effect[17]; serum glucose may be normal[3]
- euglycemic DKA
- urinary tract infections[2] (candidiasis)[3]
- no increased risk of severe urinary tract infections[13]
- genital infections (vulvovaginal candidiasis)[3]
- increased risk for balanitis & vulvovaginitis related to glucosuria[28]
- see vulvovaginal candidiasis for management
- renal insufficiency
- nocturia[23]
- reports of nephrolithiasis*[4]
- SGLT2 inhibitors are associated with lower risk for serious renal events than DPP-4 inhibitors[16]
- hypersensitivity reactions[3]
- increased risk of foot amputations & toe amputations (RR=2.1)[9] osteomyelitis (RR=1.4); absolute risk low[7]
- no increased risk of fractures in older adults with type 2 diabetes[22][32]
- sepsis[12]
- necrotizing fasciitis of the perineum, Fournier's gangrene (rare)[8][12]
- 70% of victims are men[12]
- increased risk of frailty[41]
- no evidence of dose-dependent overall safety observed in clinical usage of SGLT2 inhibitors[20]
- no additional risk of adverse effects in patients with elevated HbA1c levels[30]
* FDA decides no action necessary[4]
- drug adverse effects of hypoglycemic agents
- drug adverse effects of oral glucosuric agent; SGLT-2 inhibitor; flozin
Drug interactions
- increased risk of hypoglycemia in combination with insulin & insulin scretagogues
- increased risk of hypotension & hypovolemia in combination with diuretics[33][34][35]
- drug interaction(s) SGLT2 inhibitors (flozins) with diuretics
- drug interaction(s) of SGLT-2 inhititor (flozin) in combination with GLP1-agonist
- drug interaction(s) of aldosterone antagonists with SGLT2-inhibitor
- drug interaction(s) of fluoroquinolones with hypoglycemic agents
Mechanism of action
- reduction of blood glucose by increasing glucosuria
- all flozins inhibit sodium-glucose cotransporter 2 (SGLT2) thus inhibiting reuptake of glucose by the renal tubules
- can lower systolic blood pressure 4-8 mm Hg[35]
Notes
- empagliflozin more effective than dapagliflozin in reducing hospitalization or all-cause mortality[40]
- compliance with guideline recommended administration of SGLT2 inhibitor to eligible hospitalized patients with HFrEF, including patients with comorbid chronic renal insufficiency & diabetes mellitus type-2[36]
More general terms
More specific terms
- bexagliflozin (Brenzavvy)
- canagliflozin (Invokana)
- dapagliflozin (Farxiga, Xigduo XR)
- empagliflozin (Jardiance)
- ertugliflozin (Steglatro)
- sotagliflozin (Zynquista)
- velagliflozin (Senvelgo)
Additional terms
References
- ↑ 1.0 1.1 FDA MedWatch. May 15, 2015 SGLT2 inhibitors: Drug Safety Communication - FDA Warns Medicines May Result in a Serious Condition of Too Much Acid in the Blood. https://mail.google.com/mail/u/0/?tab=wm#inbox/14d587f1089e0791
- ↑ 2.0 2.1 FDA Safety Alert. Dec 4, 2015 SGLT2 Inhibitors: Drug Safety Communication - Labels to Include Warnings About Too Much Acid in the Blood and Serious Urinary Tract Infections. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm475553.htm
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Medical Knowledge Self Assessment Program (MKSAP) 17, 19 American College of Physicians, Philadelphia 2015, 2022
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 4.0 4.1 4.2 Lowes R New FDA Watch List Flags More Drugs Medscape Internal Medicine. July 3, 2017 http://www.medscape.com/viewarticle/882425
- ↑ 5.0 5.1 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/
- ↑ 6.0 6.1 Zheng SL, Roddick AJ, Aghar-Jaffar R, et al Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes. A Systematic Review and Meta-analysis. JAMA. 2018;319(15):1580-1591. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29677303 https://jamanetwork.com/journals/jama/fullarticle/2678616
- ↑ 7.0 7.1 Chang HY, Singh S, Mansour O, Baksh S, Alexander GC Association between sodium-glucose cotransporter 2 inhibitors and lower extremity amputation among patients with type 2 diabetes. JAMA Intern Med 2018 Aug 13; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30105373
Fralick M, Patorno E, Fischer MA Sodium-glucose cotransporter 2 inhibitors and the risk of amputation: Results and challenges from the real world. JAMA Intern Med 2018 Aug 13; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30105365 - ↑ 8.0 8.1 FDA Safety Alert. Ag 29, 2018 SGLT2(sodium-glucose cotransporter-2) Inhibitors for Diabetes: Drug Safety Communication - Regarding Rare Occurrences of a Serious Infection of the Genital Area. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm618908.htm
- ↑ 9.0 9.1 9.2 Ueda P, Svanstrom H, Melbye M et al Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study. BMJ 2018;363:k4365 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30429124 https://www.bmj.com/content/363/bmj.k4365
- ↑ 10.0 10.1 10.2 10.3 Zelniker TA, Wiviott SD, Raz I et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials. Lancet 2018 Nov 10; [e-pub]. (https://doi.org/10.1016/S0140-6736(18)32590-X) PMID: https://www.ncbi.nlm.nih.gov/pubmed/30424892
Verma S, Juni P, Mazer CD. Pump, pipes, and filter: Do SGLT2 inhibitors cover it all? Lancet 2018 Nov 10; PMID: https://www.ncbi.nlm.nih.gov/pubmed/30424891 - ↑ 11.0 11.1 Writing Committee, Das SR, Everett BM, Birtcher KK et al 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease. A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. Nov 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30497881 <Internet> http://www.onlinejacc.org/content/early/2018/11/23/j.jacc.2018.09.020
- ↑ 12.0 12.1 12.2 12.3 Bersoff-Matcha SJ, Chamberlain C, Cao C et al Fournier Gangrene Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases. Ann Intern Med. 2019. May 7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31060053 https://annals.org/aim/article-abstract/2732837/fournier-gangrene-associated-sodium-glucose-cotransporter-2-inhibitors-review-spontaneous
- ↑ 13.0 13.1 Dave CV, Schneeweiss S, Kim D et al Sodium-Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study. Ann Intern Med. 2019. July 30 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31357213 https://annals.org/aim/article-abstract/2739786/sodium-glucose-cotransporter-2-inhibitors-risk-severe-urinary-tract-infections
Filion KB, Yu OH Sodium-Glucose Cotransporter-2 Inhibitors and Severe Urinary Tract Infections: Reassuring Real-World Evidence. Ann Intern Med. 2019. July 30 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31357211 https://annals.org/aim/article-abstract/2739787/sodium-glucose-cotransporter-2-inhibitors-severe-urinary-tract-infections-reassuring - ↑ 14.0 14.1 Pasternak B, Ueda P, Eliasson B et al. Use of sodium glucose cotransporter 2 inhibitors and risk of major cardiovascular events and heart failure: Scandinavian register based cohort study. BMJ 2019 Aug 29; 366:l4772. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31467044 Free PMC Article https://www.bmj.com/content/366/bmj.l4772
- ↑ 15.0 15.1 Fralick M, Chen SK, Patorno E, Kim SC. Assessing the Risk for Gout With Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Type 2 Diabetes: A Population-Based Cohort Study. Ann Intern Med. 2020. Jan 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31931526 https://annals.org/aim/article-abstract/2758844/assessing-risk-gout-sodium-glucose-cotransporter-2-inhibitors-patients-type
McCormick N, Yokose C, Wei J et al Comparative Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors for Recurrent Gout Flares and Gout-Primary Emergency Department Visits and Hospitalizations. A General Population Cohort Study. Ann Intern Med. 2023 Jul 25 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37487215 https://www.acpjournals.org/doi/full/10.7326/M23-0724
Wei J, Choi HK, Dalbeth M et al Gout Flares and Mortality After Sodium-Glucose Cotransporter-2 Inhibitor Treatment for Gout and Type 2 Diabetes. JAMA Netw Open. 2023;6(8):e2330885 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37624597 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808753 - ↑ 16.0 16.1 16.2 Pasternak B et al Use of sodium-glucose co-transporter 2 inhibitors and risk of serious renal events: Scandinavian cohort study. BMJ 2020;369:m1186 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32349963 https://www.bmj.com/content/369/bmj.m1186
Smith SM SGLT2 inhibitors and kidney outcomes in the real world. BMJ 2020;369:m1584 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32349997 https://www.bmj.com/content/369/bmj.m1584 - ↑ 17.0 17.1 17.2 Douros A et al. Sodium-glucose cotransporter-2 inhibitors and the risk for diabetic ketoacidosis: A multicenter cohort study. Ann Intern Med 2020 Jul 28; PMID: https://www.ncbi.nlm.nih.gov/pubmed/32716707 https://www.acpjournals.org/doi/10.7326/M20-0289
- ↑ 18.0 18.1 Zannad F et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: A meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet 2020 Aug 30; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32877652 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31824-9/fulltext
- ↑ 19.0 19.1 Filion KB et al Sodium glucose cotransporter 2 inhibitors and risk of major adverse cardiovascular events: multi-database retrospective cohort study. BMJ 2020;370:m3342 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32967856 Free article https://www.bmj.com/content/370/bmj.m3342
- ↑ 20.0 20.1 Shi FH, Li H, Yue J et al Clinical Adverse Events of High-Dose vs Low-Dose Sodium-Glucose Cotransporter 2 Inhibitors in Type 2 Diabetes. A Meta-Analysis of 51 Randomized Clinical Trials. J Clin Endocrinol Metab. 2020;105(11) PMID: https://www.ncbi.nlm.nih.gov/pubmed/32841351 https://www.medscape.com/viewarticle/938944
- ↑ Goldberg LR. The pleiotropic effects of SGLT2 inhibitors: Remodeling the treatment of heart failure. J Am Coll Cardiol 2021 Jan 26; 77:256. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33478648 https://www.sciencedirect.com/science/article/abs/pii/S0735109720378931
- ↑ 22.0 22.1 Monaco K SGLT-2 Inhibitors Cleared of Bone Fracture Qualms in Older T2D Patients. New Medicare users of three classes of antidiabetic agents were compared. MedPage Today October 27, 2021 https://www.medpagetoday.com/endocrinology/diabetes/95290
Zhuo M, Hawley CE, Paik JM et al Association of Sodium-Glucose Cotransporter-2 Inhibitors With Fracture Risk in Older Adults With Type 2 Diabetes. JAMA Netw Open. 2021;4(10):e2130762 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34705014 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785536 - ↑ 23.0 23.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ 24.0 24.1 Zou X et al. Sodium-glucose cotransporter-2 inhibitors in patients with heart failure: A systematic review and meta-analysis. Ann Intern Med 2022 Apr 12; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35404670 https://www.acpjournals.org/doi/10.7326/M21-4284
- ↑ 25.0 25.1 25.2 Tucker ME SGLT-2 inhibitors as First-Line Therapy in Type 2 Diabetes? Medscape. May 23, 2022 https://www.medscape.com/viewarticle/974463
Shin H et al Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors Versus Metformin. A Cohort Study. Ann Intern Med 2022. May 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35605236 https://www.acpjournals.org/doi/10.7326/M21-4012 - ↑ 26.0 26.1 Vaduganathan M et al. SGLT-2 inhibitors in patients with heart failure: A comprehensive meta-analysis of five randomised controlled trials. Lancet 2022 Sep 3; 400:757. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36041474 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01429-5/fulltext
- ↑ 27.0 27.1 Schechter M et al. Effects of dapagliflozin on hospitalizations in patients with chronic kidney disease: A post hoc analysis of DAPA-CKD. Ann Intern Med 2022 Dec 6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36469914 https://www.acpjournals.org/doi/10.7326/M22-2115
- ↑ 28.0 28.1 Schwartz B Fast Five Quiz: Penis Conditions and Disorders Medscape. Nov 29, 2022 https://reference.medscape.com/viewarticle/984322
- ↑ 29.0 29.1 Goldman A, Fishman B, Twig G et al The real-world safety profile of sodium-glucose co-transporter-2 inhibitors among older adults (>= 75 years): a retrospective, pharmacovigilance study. Cardiovascular Diabetology. 2023 22(1):16 Jan 24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36694178 PMCID: PMC9875397 Free PMC article https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-01743-5
- ↑ 30.0 30.1 30.2 D'Andrea E et al. Comparing effectiveness and safety of SGLT2 inhibitors vs DPP-4 inhibitors in patients with type 2 diabetes and varying baseline HbA1c levels. JAMA Intern Med 2023 Feb 6; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36745425 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2800884
- ↑ 31.0 31.1 31.2 Cohen LP, Isaza N, Hernandez I et al Cost-effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors for the Treatment of Heart Failure With Preserved Ejection Fraction. JAMA Cardiol. 2023;8(5):419-428. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36870047 PMCID: PMC9985815 (available on 2024-03-04) https://jamanetwork.com/journals/jamacardiology/fullarticle/2802215
Sandhu AT, Cohen DJ Cost-effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors for Patients With Heart Failure and Preserved Ejection Fraction - Living on the Edge. JAMA Cardiol. 2023;8(5):415-416 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36870043 https://jamanetwork.com/journals/jamacardiology/fullarticle/2802216 - ↑ 32.0 32.1 Saito T et al Impact of sodium-glucose cotransporter-2 inhibitors on the risk of hip fracture in older patients in Japan using a nationwide administrative claims database: A matched case-control study. Geriatr Gerontol Int. 2023. May 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37139826 https://onlinelibrary.wiley.com/doi/abs/10.1111/ggi.14591
- ↑ 33.0 33.1 Baker WL, Smyth LR, Riche DM, Bourret EM, Chamberlin KW, White WB. Effects of sodium-glucose co-transporter 2 inhibitors on blood pressure: a systematic review and meta-analysis. J Am Soc Hypertens. 2014 Apr;8(4):262-75.e9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24602971 Review.
- ↑ 34.0 34.1 Dubrofsky L, Srivastava A, Cherney DZ Sodium-Glucose Cotransporter-2 Inhibitors in Nephrology Practice: A Narrative Review. Can J Kidney Health Dis. 2020 Jun 24;7:2054358120935701. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32637144 PMCID: PMC7315675 Free PMC article. Review.
- ↑ 35.0 35.1 35.2 NEJM Knowledge+ Endocrinology
- ↑ 36.0 36.1 Pierce JB, Vaduganathan M, Fonarow GC et al Contemporary Use of Sodium-Glucose Cotransporter-2 Inhibitor Therapy Among Patients Hospitalized for Heart Failure With Reduced Ejection Fraction in the US. The Get With The Guidelines - Heart Failure Registry. JAMA Cardiol. 2023;8(7):652-661 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37212192 PMCID: PMC10203967 (available on 2024-05-22) https://jamanetwork.com/journals/jamacardiology/fullarticle/2805332
- ↑ 37.0 37.1 37.2 Rigato M, Fadini GP, Avogaro A. Safety of sodium-glucose cotransporter 2 inhibitors in elderly patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023. Jul 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37402697
Tumminia A, Graziano M, Vinciguerra F, Lomonaco A, Frittita L. Efficacy, renal safety and tolerability of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in elderly patients with type 2 diabetes: A real-world experience. Prim Care Diabetes. 2021. Apr;15(2):283-288 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33129749
Wang Y, Shao X, Liu Z. Efficacy and safety of sodium-glucose co-transporter 2 inhibitors in the elderly versus non-elderly patients with type 2 diabetes mellitus: a meta-analysis. Endocr J. 2022 Jun 28;69(6):669-679. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35314533 Free article. - ↑ 38.0 38.1 38.2 Gao M, Bhatia K, Kapoor A et al SGLT2 Inhibitors, Functional Capacity, and Quality of Life in Patients With Heart Failure: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024 Apr 1;7(4):e245135. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38573633 Free article. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817144
- ↑ 39.0 39.1 39.2 Yen FS, Hwi CM, Liu JS et al Sodium-Glucose Cotransporter-2 Inhibitors and the Risk for Dialysis and Cardiovascular Disease in Patients With Stage 5 Chronic Kidney Disease. Ann Intern Med, 2024. April 30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38684099 https://www.acpjournals.org/doi/10.7326/M23-1874
- ↑ 40.0 40.1 Modzelewski KL, Pipilas A, Bosch NA Comparative Outcomes of Empagliflozin to Dapagliflozin in Patients With Heart Failure. JAMA Netw Open. 2024;7(5):e249305 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38696170 PMCID: PMC11066699 Free PMC article. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2818219
- ↑ 41.0 41.1 Nishimura A et al Older Adults with Type 2 Diabetes: A Cross-Sectional Study. Drugs Aging. 2024. May 24 Not indexed in PubMed https://link.springer.com/article/10.1007/s40266-024-01119-8
- ↑ 42.0 42.1 Bidulka P, Lugo-Palacios DG, Carroll O, et al. Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: Emulation of a target trial using routinely collected health data. BMJ 2024 May 8; 385:e077097. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38719492 PMCID: PMC11077536 Free PMC article.
- ↑ 43.0 43.1 43.2 43.3 Patel SM, Kang YM, Im K et al. Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis. Circulation. 2024 Jun 4;149(23):1789-1801 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38583093 PMCID: PMC11149938 Free PMC article.
- ↑ 44.0 44.1 Usman MS, Bhatt DL, Hameed I et al Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2024 Jul;12(7):447-461. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38768620
- ↑ 45.0 45.1 Writing Committee; Hollenberg SM, Stevenson LW, Ahmad T et al 2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update: A Report of the American College of Cardiology Solution Set Oversight Committee J Am Coll Cardiol. 2024 Aug 2:S0735-1097(24)07449-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39127954 https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002
- ↑ 46.0 46.1 Chen TY, Lee HF, Chan YH, Chuang C, Li PR, Yeh YH, Su HC, See LC. Comparing clinical outcomes in patients with type 2 diabetes mellitus after ischaemic stroke: Sodium-glucose cotransporter 2 inhibitors users versus non-users. A propensity score matching National Cohort Study. Diabetes Obes Metab. 2024 Aug 12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39134462
- ↑ 47.0 47.1 Usman MS, Bhatt DL, Hameed I, et al. Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2024 Jul;12(7):447-461 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38768620
- ↑ 48.0 48.1 Neuen BL, Fletcher RA, et al. Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials. Lancet Diabetes Endocrinol. 2024 Aug;12(8):545-557 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38991584
- ↑ An J, Sim JJ, Zhou MM et al. Blood pressure reduction and changes in antihypertensive medication use among patients with hypertension who initiated sodium-glucose cotransporter-2 inhibitors. J Clin Hypertens (Greenwich) 2024 Nov; 26:1318 PMID: https://www.ncbi.nlm.nih.gov/pubmed/39373635 PMCID: PMC11555531 Free PMC article https://onlinelibrary.wiley.com/doi/10.1111/jch.14915
- ↑ 50.0 50.1 Ostrominski JW, Hojbjerg Lassen MC, Claggett BL, et al. Sodium-glucose co-transporter 2 inhibitors and new-onset diabetes in cardiovascular or kidney disease. Eur Heart J. 2024 Nov 21:ehae780 PMID: https://www.ncbi.nlm.nih.gov/pubmed/39568016 https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehae780/7905901