Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are currently recommended in patients with type 2 diabetes (T2D) to reduce serum glucose levels. Moreover, robust evidence has clearly demonstrated their beneficial cardiovascular and renal effects, making this class of drugs pivotal for the treatme...

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Main Authors: Alessandro Cuttone, Vittorio Cannavò, Raouf Mastan Sheik Abdullah, Pierluigi Fugazzotto, Giada Arena, Simona Brancati, Andrea Muscarà, Carmela Morace, Cristina Quartarone, Domenica Ruggeri, Giovanni Squadrito, Giuseppina Tiziana Russo
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Cells
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Online Access:https://www.mdpi.com/2073-4409/14/9/668
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author Alessandro Cuttone
Vittorio Cannavò
Raouf Mastan Sheik Abdullah
Pierluigi Fugazzotto
Giada Arena
Simona Brancati
Andrea Muscarà
Carmela Morace
Cristina Quartarone
Domenica Ruggeri
Giovanni Squadrito
Giuseppina Tiziana Russo
author_facet Alessandro Cuttone
Vittorio Cannavò
Raouf Mastan Sheik Abdullah
Pierluigi Fugazzotto
Giada Arena
Simona Brancati
Andrea Muscarà
Carmela Morace
Cristina Quartarone
Domenica Ruggeri
Giovanni Squadrito
Giuseppina Tiziana Russo
author_sort Alessandro Cuttone
collection DOAJ
description Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are currently recommended in patients with type 2 diabetes (T2D) to reduce serum glucose levels. Moreover, robust evidence has clearly demonstrated their beneficial cardiovascular and renal effects, making this class of drugs pivotal for the treatment of T2D, especially when complicated by diabetic kidney disease or heart failure. However, several other comorbidities are frequently encountered in T2D patients beyond these long-term diabetes complications, especially in the internal medicine setting. For some of these comorbidities, such as MAFLD and cognitive impairment, the association with diabetes is increasingly recognized, with the hypothesis of a common pathophysiologic background, whereas, for others, a coincident epidemiology linked to the ageing of populations, including that of T2D subjects, may be advocated. In the effort of personalizing T2D treatment, evidence on the potential effects of SGLT2i in these different clinical conditions is accumulating. The purpose of this narrative review is to update current literature on the effects of SGLT2i for the treatment of T2D in different clinical settings beyond glycaemic control, and to elucidate potential molecular mechanisms by which they exert these effects.
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spelling doaj-art-b5f3e4c40c1c4812bc0e8e45471230ce2025-08-20T02:30:46ZengMDPI AGCells2073-44092025-05-0114966810.3390/cells14090668Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical SettingsAlessandro Cuttone0Vittorio Cannavò1Raouf Mastan Sheik Abdullah2Pierluigi Fugazzotto3Giada Arena4Simona Brancati5Andrea Muscarà6Carmela Morace7Cristina Quartarone8Domenica Ruggeri9Giovanni Squadrito10Giuseppina Tiziana Russo11Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyInternal Medicine and Diabetology Unit, University Hospital of Messina, 98124 Messina, ItalyInternal Medicine and Diabetology Unit, University Hospital of Messina, 98124 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, 98100 Messina, ItalySodium-glucose cotransporter-2 inhibitors (SGLT2i) are currently recommended in patients with type 2 diabetes (T2D) to reduce serum glucose levels. Moreover, robust evidence has clearly demonstrated their beneficial cardiovascular and renal effects, making this class of drugs pivotal for the treatment of T2D, especially when complicated by diabetic kidney disease or heart failure. However, several other comorbidities are frequently encountered in T2D patients beyond these long-term diabetes complications, especially in the internal medicine setting. For some of these comorbidities, such as MAFLD and cognitive impairment, the association with diabetes is increasingly recognized, with the hypothesis of a common pathophysiologic background, whereas, for others, a coincident epidemiology linked to the ageing of populations, including that of T2D subjects, may be advocated. In the effort of personalizing T2D treatment, evidence on the potential effects of SGLT2i in these different clinical conditions is accumulating. The purpose of this narrative review is to update current literature on the effects of SGLT2i for the treatment of T2D in different clinical settings beyond glycaemic control, and to elucidate potential molecular mechanisms by which they exert these effects.https://www.mdpi.com/2073-4409/14/9/668SGLT2iT2DCVOTscardiovascular effectsrenal effectsbone metabolism
spellingShingle Alessandro Cuttone
Vittorio Cannavò
Raouf Mastan Sheik Abdullah
Pierluigi Fugazzotto
Giada Arena
Simona Brancati
Andrea Muscarà
Carmela Morace
Cristina Quartarone
Domenica Ruggeri
Giovanni Squadrito
Giuseppina Tiziana Russo
Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
Cells
SGLT2i
T2D
CVOTs
cardiovascular effects
renal effects
bone metabolism
title Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
title_full Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
title_fullStr Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
title_full_unstemmed Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
title_short Expanding the Use of SGLT2 Inhibitors in T2D Patients Across Clinical Settings
title_sort expanding the use of sglt2 inhibitors in t2d patients across clinical settings
topic SGLT2i
T2D
CVOTs
cardiovascular effects
renal effects
bone metabolism
url https://www.mdpi.com/2073-4409/14/9/668
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