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Objective: Type 2 Diabetes Mellitus (T2DM) is among the major risk factors for both cardiovascular (CVDs) and renal diseases. The management of both cardiovascular risk and progression of kidney disease thus seem crucial in the treatment of the diabetic patient. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been associated with a remarkable reduction of cardiovascular and renal mortality, lower hospitalization rates for heart failure and lower progression of renal damage and albuminuria. The aim of our study was to assess SGLT2i effects on both cardio- and renal protection in diabetic patients. Design and method: Our study including elderly patients (>65 years) with T2DM, divided in two groups, one group treated with iSGLT2, and the other without. Data were collected at the beginning of treatment, 3, 6, 9 and 12 months after. HbA1C, BMI, GFR and renal parameters, uric acid, NTproBNP, echocardiography, PAS and PAD values, were evaluated in every meetings, in both groups. Results: A total of 298 elderly diabetic patients were included, at 198 of them dapagliflozin 10 mg, was initiated. At 12 months, HbA1c, weight, systolic blood pressure, NTproBNP, uric acid, albuminuria, were lower in group with dapagliflozin versus the other group without it, and estimated glomerular filtration rate was higher (75.3 – 87.19mL/min/1.73m2; p<0.005). Follow up in patients with SGLT2i showed a significant decrease in left ventricular end-diastolic dimension (LV-EDD) (62.86 mm to 54.85 mm; P< 0.001) and improvement in LV-EF. The SGLT2i-induced improvements in cardiac function were more prominent in HF patients than those without HF. Conclusions: The use of Dapagliflozin showed metabolic benefits in patients with T2D with clinically significant reductions in HbA1c, blood pressure, weight, uric acid, and NTproBNP. Cardiovascular and renal benefits were shown, also. So, SGLT2i has a significant effect in both, cardio- and renal protection in diabetic patients.
Nelaj et al. (Wed,) studied this question.