Effects of Sodium Glucose Cotransporters (SGLT2) Inhibitorstype 2 on Hepatosis in Patients Type 2 Diabetes Mellitus

Abstract

Diabetes mellitus is a major public health disorder that affects more than 400 million subjects, with a prevalence ranging from 7.2 to 11.4% in the general population,worldwide [1, 2]. Diabetes is associated with various metabolic disorders and vascular damage of great extent [3] and thus, the management of the diabetic patient should aim in the attenuation of hyperglycemia and other concomitant cardiovascular conditions [4-7]. Current antidiabetic treatment options were unable to offer consistent cardiovascular benefits. Apart from metformin and glucagon-like peptide 1 analogues, the rest of the available hypoglycemic agents have not provided consistent benefits from the cardiovascular standpoint. Furthermore, the impact of these drugs on other cardiovascular risk factors is either neutral or beneficial, and in some cases even harmful [8-15].Sodium-glucose co-transporters (SGLT) 2 inhibitors area novel antidiabetic class of drugs that offer a different approach for the amelioration of hyperglycemia than the other antidiabetic drug classes. SGLT-2 inhibitors block the reabsorption of glucose in the renal proximal tubule,resulting in decreased glucose reabsorption, increased urine excretion of glucose and attenuation of glycemic parameters [6, 7]. Through their unique mechanism of action, SGLT-2 inhibitors seem to offer several beneficial effects on a cluster of other cardiovascular risk factors. These drugs are associated with a mild increase in sodium urine excretion; this combined with the osmotic effect of the excreted glucose, results in a mild diuretic effect that leads to hemodynamic improvements. A mild decrease in blood pressure accompanied with a mild reduction in body weight is noted with SGLT-2 inhibition. In addition, beneficial effects with these drugs are observed in serum acid levels, triglycerides and high-density lipoprotein cholesterol levels. Ameliorating effects are also noted in other established cardiovascular risk factors such as diabetic nephropathy, non-alcoholic fatty liver disease and arterial stiffness [8, 9].