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SGLT-2 inhibitors in diabetes: a focus on renoprotection
Gonzalez, Diego Ennes; Foresto, Renato Demarchi; Ribeiro, Artur Beltrame.
  • Gonzalez, Diego Ennes; Hospital do Rim. Escola Paulista de Medicina. Fundação Oswaldo Ramos. São Paulo. BR
  • Foresto, Renato Demarchi; Hospital do Rim. Escola Paulista de Medicina. Fundação Oswaldo Ramos. São Paulo. BR
  • Ribeiro, Artur Beltrame; Hospital do Rim. Fundação Oswaldo Ramos. São Paulo. BR
Rev. Assoc. Med. Bras. (1992) ; 66(supl.1): s17-s24, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057108
Responsible library: BR1.1
ABSTRACT
SUMMARY Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding the reduction of cardiovascular mortality, reduction of hospitalization due to heart failure, reduction of albuminuria, and long-term maintenance of the glomerular filtration rate. The benefit from SGLT2 inhibitors stems from its main mechanism of action, which occurs in the proximal tubule of the nephron, causing glycosuria, and a consequent increase in natriuresis. This leads to increased sodium intake by the juxtaglomerular apparatus, activating the tubule glomerular-feedback and, finally, reducing intraglomerular hypertension, a frequent physiopathological condition in kidney disease caused by diabetes. In addition, this class of medication presents an appropriate safety profile, and its most frequently reported complication is an increase in the incidence of genital infections. Thus, these hypoglycemic agents gained space in practical recommendations for the management of type 2 diabetes mellitus and should be part of the initial therapeutic approach to provide, in addition to glycemic control, cardiovascular outcomes, and the renoprotection in the long term.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Cardiovascular Diseases / Diabetes Mellitus, Type 2 / Sodium-Glucose Transporter 2 / Sodium-Glucose Transporter 2 Inhibitors / Hypoglycemic Agents / Kidney Diseases Type of study: Risk factors Limits: Humans Language: English Journal: Rev. Assoc. Med. Bras. (1992) Journal subject: Educa‡Æo em Sa£de / GestÆo do Conhecimento para a Pesquisa em Sa£de / Medicine Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital do Rim/BR

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Full text: Available Index: LILACS (Americas) Main subject: Cardiovascular Diseases / Diabetes Mellitus, Type 2 / Sodium-Glucose Transporter 2 / Sodium-Glucose Transporter 2 Inhibitors / Hypoglycemic Agents / Kidney Diseases Type of study: Risk factors Limits: Humans Language: English Journal: Rev. Assoc. Med. Bras. (1992) Journal subject: Educa‡Æo em Sa£de / GestÆo do Conhecimento para a Pesquisa em Sa£de / Medicine Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital do Rim/BR