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  • The Review Course in Family Medicine

Sodium–Glucose Cotransporter-2 (SGLT2) Inhibitors Are Not Just For Diabetes Anymore




Even without diabetes, many of your patients can have huge benefits on SGLT2 inhibitors.


  • Moderate chronic kidney disease (CKD) (eGFRs¹ < 45, or uACR² > 25): reduces progression of CKD

  • Clinical heart failure: reduces hospitalization and mortality from heart failure regardless of Ejection Fraction (EF)

  • Hypertension: Systolic blood pressure (BP) reduction within 3 months

  • Obesity: weight loss of 2kg


You can expect a drop in eGFR after initiation and repeat testing of eGFR is not needed.


Remember to counsel patients about an increased risk of genital mycotic infections including vaginitis and balanitis. Vaginitis can often be managed easily with a single dose of oral fluconazole. Yeast balanitis typically responds to topical treatments such as clotrimazole or nystatin, though for severe cases oral fluconazole single dose works as well.


There is no risk for euglycemic ketoacidosis or hypoglycemia in non-diabetic patients.


By incorporating SGLT2 inhibitors into your clinical toolkit, you can unlock a range of advantages for your patients. For further insights, see the references below.


¹ estimated Glomerular Filtration Rate

² urine Albumin-Creatinine Ratio



References


Sodium-glucose cotransporte<•2 lnhl>ltors In pallents without diabetes

Elise Frymt and Matthew B. Lankttee

CMAJ May 01, 2023195 (17) E619: 001: hltQS:lldolotg/10.1503/cma,.221691

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