Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have transformed diabetes management by targeting renal glucose reabsorption. Designed initially as antidiabetic agents, their ability to lower blood glucose
levels independently of insulin is well-documented. Beyond glycemic control, emerging research has unveiled their profound cardiorenal benefits. By
inhibiting SGLT-2 protein, these drugs enhance glucose excretion in urine,
reducing blood glucose levels. This mechanism has translated into significant cardiovascular and renal protection, establishing SGLT-2 inhibitors as
pivotal in managing not only diabetes but also cardiovascular and renal
diseases. Recent studies have illuminated the broader therapeutic potential
of SGLT-2 inhibitors beyond diabetes. Evidence indicates their efficacy in
managing heart failure, chronic kidney disease (CKD), and cardiovascular
complications in individuals with or without diabetes. This expanded therapeutic landscape has catalyzed a paradigm shift in SGLT-2 inhibitor use,
positioning them as key agents in the cardiorenal metabolic continuum.
Moreover, their role in the secondary prevention of cardiovascular events
and slowing CKD progression in T2DM patients has garnered considerable
attention. This consensus-based review aims to offer practical guidance in an algorithmic approach to primary care healthcare professionals to optimize SGLT-2 inhibitors utilization and maximize their benefits. The review
seeks to empower clinicians to effectively manage patients who may benefit
from SGLT-2 inhibitor therapy by addressing common initiation barriers
and optimizing treatment strategies. Additionally, it aims to raise awareness
among primary care physicians regarding the multifaceted benefits of these
medications and overcome clinical inertia in their adoption into routine
clinical practice.
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