Perspectives of Diabetes, Heart Failure and Chronic Kidney Disease (CKD) Treating By Sodium-Glucose Cotransporter-2 Inhibitor (SGLT2i)

Sodium-glucose cotransporter-2 inhibitor (SGLT2i) was initially applied to diabetes, successively to heart failure and recently to chronic kidney disease (CKD) with its expanding application. For decades, several cardiovascular outcome trials (CVOT) have been conducted for SGLT2i. They include mega studies of CREDENCE, CANVAS, DECLARE-TIMI 58, EMPA-REG OUTCOME, EMPA-KIDNEY, EMPEROR-Reduced, DAPA-HF, DAPA-CKD, and others. DAPA-CKD is an on-going study for non-DM cases. Recommendations for actual medical practice of SGLT2i include i) careful combined treatment of diuretics, ii) checking urinary ketones against ketosis, iii) avoiding the first-line agent, and iv) establishing basically reasonable lifestyle and nutrition in addition to medical agents.

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