Weight Loss Effect of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in Patients with Obesity without Diabetes: a Systematic Review

Tandarto, Kevin; Hengky, Antoninus

doi:10.4183/aeb.2022.216

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…In addition, the loss of glucose from urine results in the loss of calories. This has been proven to result in weight loss in patients [50]. Moreover, a statistically significant decrease in systolic blood pressure by about 3-4 mmHg and diastolic blood pressure by 1-2 mmHg was also observed [51].…”

Section: Pleiotropic Effects Of Sglt2 Inhibitorsmentioning

confidence: 85%

SGLT2 Inhibitors in Kidney Diseases—A Narrative Review

Gajewska,

Wasiak,

Sapeda

et al. 2024

IJMS

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Some of the most common conditions affecting people are kidney diseases. Among them, we distinguish chronic kidney disease and acute kidney injury. Both entities pose serious health risks, so new drugs are still being sought to treat and prevent them. In recent years, such a role has begun to be assigned to sodium-glucose cotransporter-2 (SGLT2) inhibitors. They increase the amount of glucose excreted in the urine. For this reason, they are currently used as a first-line drug in type 2 diabetes mellitus. Due to their demonstrated cardioprotective effect, they are also used in heart failure treatment. As for the renal effects of SGLT2 inhibitors, they reduce intraglomerular pressure and decrease albuminuria. This results in a slower decline in glomelular filtration rate (GFR) in patients with kidney disease. In addition, these drugs have anti-inflammatory and antifibrotic effects. In the following article, we review the evidence for the effectiveness of this group of drugs in kidney disease and their nephroprotective effect. Further research is still needed, but meta-analyses indicate SGLT2 inhibitors' efficacy in kidney disease, especially the one caused by diabetes. Development of new drugs and clinical trials on specific patient subgroups will further refine their nephroprotective effects.

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Section: Pleiotropic Effects Of Sglt2 Inhibitorsmentioning

confidence: 85%

SGLT2 Inhibitors in Kidney Diseases—A Narrative Review

Gajewska,

Wasiak,

Sapeda

et al. 2024

IJMS

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“…While their main focus is not on adipose tissue, there is evidence to support the notion that SGLT-2 inhibitors may have an impact on fat metabolism [47]. According to some study findings, these inhibitors, especially in T2DM patients, may result in a small amount of weight loss [48,49] and a decrease in body fat, especially by decreasing TAG (triglyceride) accumulation [50]. Yet, more investigation is required to completely understand how SGLT-2 inhibitors affect adipose tissue and how this affects how fat is metabolized.…”

Section: Mechanism Of Action Of Sglt-2 Inhibitorsmentioning

confidence: 99%

The Ketogenic Effect of SGLT-2 Inhibitors—Beneficial or Harmful?

Koutentakis,

Kuciński,

Świeczkowski

et al. 2023

JCDD

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Sodium–glucose cotransporter-2 (SGLT-2) inhibitors, also called gliflozins or flozins, are a class of drugs that have been increasingly used in the management of type 2 diabetes mellitus (T2DM) due to their glucose-lowering, cardiovascular (CV), and renal positive effects. However, recent studies suggest that SGLT-2 inhibitors might also have a ketogenic effect, increasing ketone body production. While this can be beneficial for some patients, it may also result in several potential unfavorable effects, such as decreased bone mineral density, infections, and ketoacidosis, among others. Due to the intricate and multifaceted impact caused by SGLT-2 inhibitors, this initially anti-diabetic class of medications has been effectively used to treat both patients with chronic kidney disease (CKD) and those with heart failure (HF). Additionally, their therapeutic potential appears to extend beyond the currently investigated conditions. The objective of this review article is to present a thorough summary of the latest research on the mechanism of action of SGLT-2 inhibitors, their ketogenesis, and their potential synergy with the ketogenic diet for managing diabetes. The article particularly discusses the benefits and risks of combining SGLT-2 inhibitors with the ketogenic diet and their clinical applications and compares them with other anti-diabetic agents in terms of ketogenic effects. It also explores future directions regarding the ketogenic effects of SGLT-2 inhibitors.

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“…The EMPA-KIDNEY (empagliflozin) and DAPA-CKD (dapagliflozin) trials showed similar results in individuals with CKD, whether or not they had T2DM [ 21 , 28 , 31 ]. SGLT2i use has also been typically associated with the lowering of other CV risk factors, such as blood pressure, and recipients often experience weight loss [ 2 , 12 , 17 , 18 , 34 , 35 , 49 , 52 , 53 , 57 – 60 ]. Organ protection remains the cornerstone objective for long-term management of T2DM and the wider implementation of SGLT2is early in the therapeutic pathway would support better outcomes through the lowering of both macrovascular risk and complication severity [ 1 – 4 , 12 , 17 – 23 , 28 , 31 , 35 , 52 , 53 , 56 , 61 ].…”

Section: Back To Basics In T2dm Management: Improving Quantity and Qu...mentioning

confidence: 99%

“…SGLT2is can offer value across the natural history and continuum of T2DM. Early in the treatment pathway, value is offered through health gain associated with better metabolic outcomes, weight loss, reduced blood pressure and low risk of hypoglycaemia [ 1 , 35 , 37 , 57 – 60 ]. Progressing through the course of T2DM, SGLT2is are associated with reduced CVD, renal disease and HF, delivering health gain as well as cost savings via reduced resource utilisation and effective management of complications and releasing capacity within the system [ 3 , 4 , 17 – 22 , 28 , 29 , 31 , 41 , 44 , 53 , 55 , 56 , 75 – 77 ].…”

Section: The Cost–benefit Case For Sglt2ismentioning

confidence: 99%

SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review

Seidu,

Alabraba,

Davies

et al. 2024

Diabetes Ther

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A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM). This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable of slowing or preventing the onset of long-term cardiovascular, renal and metabolic (CVRM) complications, making their use highly applicable for organ protection and the maintenance of long-term health outcomes. SGLT2is have shown cost-effectiveness in T2DM management and economic savings over other glucose-lowering therapies due to reduced incidence of cardiovascular and renal events. National and international guidelines advocate SGLT2i use early in the T2DM management pathway, based upon a plethora of supporting data from large-scale cardiovascular outcome trials, renal outcomes trials and real-world studies. While most people with T2DM would benefit from CVRM protection through SGLT2i use, prescribing hesitancy remains, potentially due to confusion concerning their place in the complex therapeutic paradigm, variation in licensed indications or safety perceptions/misunderstandings associated with historical data that have since been superseded by robust clinical evidence and long-term pharmacovigilance reporting. This latest narrative review developed by the Improving Diabetes Steering Committee (IDSC) outlines the place of SGLT2is within current evidence-informed guidelines, examines their potential as the standard of care for the majority of newly diagnosed people with T2DM and sets into context the perceived risks and proven advantages of SGLT2is in terms of sustained health outcomes. The authors discuss the cost-effectiveness case for SGLT2is and provide user-friendly tools to support healthcare professionals in the correct application of these medicines in T2DM management. The previously published IDSC SGLT2i Prescribing Tool for T2DM Management has undergone updates and reformatting and is now available as a Decision Tool in an interactive pdf format as well as an abbreviated printable A4 poster/wall chart. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-024-01550-5.

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Weight Loss Effect of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors in Patients with Obesity without Diabetes: a Systematic Review

Cited by 8 publications

References 20 publications

SGLT2 Inhibitors in Kidney Diseases—A Narrative Review

SGLT2 Inhibitors in Kidney Diseases—A Narrative Review

The Ketogenic Effect of SGLT-2 Inhibitors—Beneficial or Harmful?

SGLT2 Inhibitors – The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review

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