The unexpected benefits of sodium glucose co-transporter 2 (SGLT2) inhibitors

Abstract

The sodium glucose co-transporter 2 (SGLT2) inhibitor empagliflozin is currently funded in New Zealand for management of patients with type 2 diabetes who have an HbA1c >53mmol/mol and a high cardiovascular (CV) risk. Large clinical trials now provide strong evidence that SGLT2 inhibitors decrease the risk of cardiovascular death, heart failure, progressive kidney dysfunction, myocardial infarction, stroke and gout. Patients with or without diabetes who have a history of heart failure, including those with a preserved left ventricular ejection fraction and patients with chronic kidney impairment are likely to benefit most from treatment with an SGLT2 inhibitor. These findings make a strong case for extending funding of SGLT2 inhibitors to include patients with heart failure or kidney dysfunction without diabetes, so many more New Zealanders could benefit.