SGLT-2 inhibitors in type 2 diabetes and effects on renal function and cardiovascular risk

Bulgarian Medical Journal, 2025, 19(4), 55-59.

N. Kostadinov

Medical Faculty, Burgas State University Prof. Dr. Asen Zlatarov – Burgas

Abstract. Type 2 diabetes mellitus (T2DM) is a global problem with increasing incidence. Diabetes mellitus is the most common cause of the development of chronic kidney disease (CKD). Early identification and management of CKD is of utmost importance to minimize the risk of major cardiovascular (CV) events. Atherosclerotic cardiovascular disease usually affects people with T2DM. In patients with T2DM, cardiovascular risk is usually reduced after healthy lifestyle changes and the use of medications to treat dyslipidemia, arterial hypertension, and antiplatelet agents. Nowadays, patients with T2DM have a wide range of new antidiabetic drugs with better efficacy and safety. In the last decade, many antihyperglycemic agents have appeared with further reduction of CV risk in diabetics. These groups of drugs are the SGLT-2 inhibitors and GLP-1 receptor agonists, and they not only lower blood glucose, but also have important benefits in terms of diabetes-related cardiovascular risk factors. The aim of the present study is to investigate the possibilities of treatment with SGLT-2 inhibitors to reduce the cardiovascular risk in patients with T2DM and atherosclerotic CV disease. The degree of influence on renal function and microalbuminuria, as factors increasing CV risk, are also investigated. Given the additional protection they provide, SGLT-2 inhibitors should be considered a mainstay in the treatment of T2DM.

Key words: diabetes mellitus type 2, glomerular filtration, microalbuminuria, SGLT-2 inhibitors

Address for correspondence: Nikolay Kostadinov, MD, e-mail: n.kostadinov_m.d@abv.bg