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

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

J Assoc Physicians India. 2021 Apr;69(4):11-12.

Authors

Mangesh Tiwaskar¹, Sanjay Kalra², Ganapathi Bantwal³, Arpandev Bhattacharya⁴, Manisha Sahay⁵, Uday Jadhav⁶, Ameya Joshi⁷, A K Das⁸, Dinesh Khullar⁹, Manash Baruah¹⁰, Hitesh Punyani¹¹, Kamal Kishor¹², Kimi Shetty¹³, Jignesh Ved¹³

Affiliations

¹ Consultant Physician & Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra.
² Consultant Endocrinologist, Bharti Hospital, Haryana.
³ Professor and Head of the Department of Endocrinology, St. Johns Medical College & Hospital, Bengaluru, Karnataka.
⁴ Consultant Endocrinologist, Manipal Hospital, Bengaluru, Karnataka.
⁵ Professor and Head of Nephrology Department, Osmania General Hospital, Hyderabad, Telangana.
⁶ Consultant Cardiologist, MGM Hospital, Navi Mumbai, Maharashtra.
⁷ Consultant Endocrinologist, Bhaktivedanta Hospital and Research Institute, Mumbai, Maharashtra.
⁸ Professor and Head of Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry.
⁹ Chairman - Nephrology and Renal Transplant Medicine, Department of Nephrology and Renal transplant medicine, Max Super Speciality Hospital, New Delhi.
¹⁰ Consultant Endocrinologist, Excel care Hospitals, Guwahati, Assam.
¹¹ Consultant Diabetologist, Apollo Cradle Hospital, New Delhi.
¹² Consultant Cardiologist, RAMA Superspeciality and Critical Care Hospital, Karnal, Haryana.
¹³ Department of Medical Affairs, Boehringer Ingelheim.

PMID: 34470191

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.

Publication types

Review

MeSH terms

Cardiovascular Diseases* / prevention & control
Diabetes Mellitus, Type 2* / drug therapy
Euphoria
Homeostasis
Humans
Hypoglycemic Agents
Sodium-Glucose Transporter 2
Sodium-Glucose Transporter 2 Inhibitors*

Substances

Hypoglycemic Agents
Sodium-Glucose Transporter 2
Sodium-Glucose Transporter 2 Inhibitors