For ISGLT2

Abstract

Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors), or gliflozins, have become a cornerstone in the fight against metabolic syndrome (MetS), offering a comprehensive approach that addresses multiple aspects of this syndrome.

SGLT2 inhibitors, such as empagliflozin, dapagliflozin, and canagliflozin, have shown great promise in improving glycemic control, reducing body weight, lowering blood pressure, and reducing uric acid levels. In addition to their hypoglycemic effects, these drugs confer significant cardioprotective and renoprotective benefits, making them a powerful tool in the comprehensive management of MetS.

SGLT2 inhibitors have demonstrated a remarkable and unexpected protective effect against damage to various organs: heart, arteries, kidneys, brain, and a reduction in events. These effects were initially associated with better control of metabolic diseases such as diabetes. However, over time and with the results obtained, functional and structural improvements were observed in these organs, even in people without diabetes. The mechanisms by which SGLT2 inhibitors exert their benefits are multifaceted. These agents reduce blood glucose levels by inhibiting glucose reabsorption in the renal proximal tubule, which produces glucosuria. This effect is insulin-independent and provides glycemic control even in patients with insulin resistance. In addition, SGLT2 inhibitors promote osmotic diuresis and natriuresis, which contributes to the reduction of plasma volume, blood pressure, and arterial stiffness. These effects not only improve metabolic parameters but also mitigate the risk of heart failure and other cardiovascular events.

Main Metabolic Benefits

• Weight loss. They promote an average reduction of approximately 1.79 kg thanks to the caloric loss from glucose eliminated in urine.
• Blood pressure control. They lower systolic and diastolic blood pressure through a mild natriuretic effect.
• Reduction of uric acid. They help lower serum uric acid levels, thus reducing the cardiovascular risk associated with hyperuricemia.
• Cardiorenal protection. They reduce structural damage to the kidneys and protect the heart, slowing the progression of multi-organ damage typical of cardiometabolic syndrome. This pharmacological group does not compete with other drugs for this condition; on the contrary, as long as there are no contraindications, many of its benefits are enhanced when combined with other medications such as metformin and GLP-1 receptor agonists.