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SGLT2 inhibitors may offer benefit beyond diabetes

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.

Key advances

  • 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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Fig. 1: Benefits of SGLT2 inhibitors to kidney and heart failure outcomes in people with and without diabetes.


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Corresponding author

Correspondence to Meg J. Jardine.

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Competing interests

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).

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