Sodium–glucose co-transporter 2 inhibitors offer impressive cardiac and kidney outcome benefits to people with type 2 diabetes mellitus (T2DM). These benefits now appear to extend to people without T2DM, according to three trials published in 2020.
Empagliflozin and dapagliflozin improved heart failure outcomes and reduced the decline in estimated glomerular filtration rate for people with heart failure and reduced ejection fraction in large outcome trials; half of the participants did not have type 2 diabetes mellitus (T2DM) at treatment initiation.
Dapagliflozin improved kidney and cardiac outcomes for people with chronic kidney disease with substantial albuminuria in a large outcome trial in which one third of people did not have T2DM at treatment initiation.
No evidence suggests that the benefits observed within the trials differs between people with or without T2DM at treatment initiation.
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A.K. is supported by an NHMRC Postgraduate Scholarship. M.J. is supported by a Medical Research Future Fund Next Generation Clinical Researchers Program Career Development Fellowship; is responsible for research projects that have received unrestricted funding from Gambro, Baxter, CSL, Amgen, Eli Lilly and MSD; has served on advisory boards sponsored by Akebia, Astra Zeneca, Baxter, Bayer, Boehringer Ingelheim, MSD and Vifor; serves on Steering Committee for trials sponsored by Janssen and CSL; has spoken at scientific meetings sponsored by Janssen, Amgen, Roche and Vifor; with any consultancy, honoraria or travel support paid to her institution.
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Kang, A., Jardine, M.J. SGLT2 inhibitors may offer benefit beyond diabetes. Nat Rev Nephrol 17, 83–84 (2021). https://doi.org/10.1038/s41581-020-00391-2