Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart.
Joseph H TaubeFahimeh VarzidehImma ForzanoScott M WilsonLuigi SalemmeAntonio de DonatoAngela LombardiAntonio RainoneCosimo NapoletanoStanislovas S JankauskasTullio TesorioGermano GuerraUrna KansakarPasquale MonePublished in: Hypertension (Dallas, Tex. : 1979) (2023)
SGLT2 (sodium-glucose cotransporter 2) enables glucose and sodium reabsorption in the kidney. SGLT2-inhibitors (gliflozins, which include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin) act by increasing glycosuria, thereby reducing glycemia. These drugs are critical to reach and keep glycemic control, a crucial feature, especially in patients with comorbidities, like frail individuals. Several studies evaluated the effects of SGLT2-inhibitors in different settings beyond diabetes, revealing that they are actually pleiotropic drugs. We recently evidenced the favorable effects of SGLT2-inhibition on physical and cognitive impairment in frail older adults with diabetes and hypertension. In the present overview, we summarize the latest clinical and preclinical studies exploring the main effects of SGLT2-inhibitors on kidney and heart, emphasizing their potential beneficial actions in frailty.
Keyphrases
- glycemic control
- type diabetes
- community dwelling
- blood glucose
- cognitive impairment
- cardiovascular disease
- heart failure
- physical activity
- blood pressure
- atrial fibrillation
- mental health
- weight loss
- machine learning
- skeletal muscle
- case control
- stem cells
- deep learning
- adipose tissue
- risk assessment
- bone marrow
- climate change
- mesenchymal stem cells
- drug induced
- cell therapy