Editorial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2020; 11(5): 150-154
Published online May 15, 2020. doi: 10.4239/wjd.v11.i5.150
Role of sodium-glucose co-transporter-2 inhibitors in the management of heart failure in patients with diabetes mellitus
Stelina Alkagiet, Konstantinos Tziomalos
Stelina Alkagiet, Department of Cardiology, Georgios Papanikolaou Hospital, Thessaloniki 57010, Greece
Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
Author contributions: Alkagiet S drafted the editorial; Tziomalos K critically revised the draft.
Conflict-of-interest statement: All authors declare no conflict of interest related to this publication.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Konstantinos Tziomalos, MD, MSc, PhD, Associate Professor, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Stilponos Kyriakidi Street, Thessaloniki 54636, Greece. ktziomalos@yahoo.com
Received: January 4, 2020
Peer-review started: January 4, 2020
First decision: February 25, 2020
Revised: February 29, 2020
Accepted: April 4, 2020
Article in press: April 4, 2020
Published online: May 15, 2020
Abstract

Heart failure (HF) is a major complication of diabetes mellitus (DM). Patients with DM have considerably higher risk for HF than non-diabetic subjects and HF is also more severe in the former. Given the rising prevalence of DM, the management of HF in diabetic patients has become the focus of increased attention. In this context, the findings of several randomized, placebo-controlled trials that evaluated the effects of sodium-glucose co-transporter-2 inhibitors on the risk of hospitalization for HF in patients with type 2 DM represent a paradigm shift in the management of HF. These agents consistently reduced the risk of hospitalization for HF both in patients with and in those without HF. These benefits appear to be partly independent from glucose-lowering and have also been reported in patients without DM. However, there are more limited data regarding the benefit of sodium-glucose co-transporter-2 inhibitors in patients with HF and preserved left ventricular ejection fraction, which is the commonest type of HF in diabetic patients.

Keywords: Heart failure, Type 2 diabetes mellitus, Sodium-glucose co-transporter-2 inhibitors, Canagliflozin, Dapagliflozin, Empagliflozin

Core tip: Sodium-glucose co-transporter-2 inhibitors substantially reduce the risk of hospitalization for heart failure in patients with type 2 diabetes mellitus (T2DM). Accordingly, these agents should be considered in all patients with T2DM and HF with reduced left ventricular ejection fraction regardless of HbA1c levels. However, more studies are needed to clarify the role of sodium-glucose co-transporter-2 inhibitors in patients with T2DM and HF with preserved left ventricular ejection fraction, which is the commonest type of HF in this population.