A recent study in JAMA Network Open has found that sodium-glucose cotransport protein 2 (SGLT2) inhibitors, a medication commonly used to manage blood sugar in people with type 2 diabetes, can also protect their hearts and kidneys. These drugs work by reducing the amount of blood sugar in the kidney by causing more glucose to be excreted in urine.
The study’s lead author, Vin-Cent Wu, MD, PhD, a nephrologist at National Taiwan University Hospital in Taipei, noted that there has been a notable absence of targeted pharmacotherapy to offer protection to patients with chronic kidney disease. In the United States, approximately 20% of people with type 2 diabetes and CKD receive a SGLT2 inhibitor, according to 2023 research.
What is Chronic Kidney Disease?
Chronic kidney disease (CKD) is when the kidneys have become damaged over time (for at least 3 months) and finds it difficult to do all their important jobs. It is a state of progressive loss of kidney function ultimately resulting in the need for renal replacement therapy (dialysis or transplantation). CKD also increases the risk of other health problems like heart disease and stroke.
Chronic kidney disease (CKD) is a condition that cannot be cured and often leads to renal failure. According to the study, SGLT2 inhibitor drugs can help protect a patient from this possibility. On the other hand, Acute kidney disease (AKD), is potentially reversible (occurring after an acute kidney injury) but can progress to CKD if left unchecked.
Diabetes Definition and Statistics in the US
Diabetes is a chronic health condition that impacts the body’s ability to efficiently convert food into energy. When you consume food, it is primarily broken down into glucose, which is then released into the bloodstream.
Elevated blood sugar levels triggers the pancreas to produce insulin, which functions as a key in facilitating the entry of glucose into the body’s cells for energy utilization.
However, in individuals with diabetes, either there is insufficient production of insulin or the body becomes resistant to its effects. Consequently, excess glucose accumulates in the bloodstream, posing greater risks of severe health complications including heart disease, vision impairment, and kidney disease over time.
In the U.S., about 38 million Americans have diabetes (about 1 in 10), and approximately 90-95% of them have type 2 diabetes, and over 9 million more have the condition although it hasn’t yet been diagnosed. Type 2 diabetes is a leading cause of chronic kidney disease.
The signs of type 2 diabetes usually progress gradually over years and may persist unnoticed for a long period. At times, the symptoms are hard to spot (occasionally, there are no discernible symptoms at all).
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Study Methods and Analysis
In the retrospective study analysis, Wu and his colleagues looked at data from more than 230,000 adults with type 2 diabetes whose health records were gathered into a research tool called the TriNetX, a global research database.
Patients included in the study were those who had been treated for acute kidney disease (AKD) between 2002 and 2022. Major adverse kidney events including heart attack, stroke, or death were noted for 5 years following their discharge. These adverse events were defined as events that required regular dialysis.
To analyze the effects of SGLT2 inhibitors, Wu and colleagues compared the outcomes among 5317 patients with AKD who received the drugs with outcomes among 5317 similar patients who did not. Members of both groups had lived for at least 90 days after being discharged from the hospital and did not require dialysis during the period.
Follow-Up Observations
However, with median follow-up on the patients for 2.3 years, it was observed that more of those patients who did not receive the SGLT2 inhibitor had died (994 compared with 481). Also more of the patients who did not receive the SGLT2 inhibitor experienced major stress to their kidneys (1119 compared with 504) or heart (612 compared with 295).
Key Takeaway
This study provides evidence that SGLT2 inhibitors can help protect the hearts and kidneys of people with type 2 diabetes. This study in JAMA Network Open has revealed that these medications not only manage blood sugar levels in type 2 diabetes, but also provide protection for your heart and kidneys. By reducing blood sugar in the kidneys and promoting glucose excretion in urine, SGLT2 inhibitors can help safeguard these vital organs.
If you have type 2 diabetes, it’s important to talk to your doctor about whether SGLT2 inhibitors are right for you.!
Sources
- CDC. (2023, April 18). Type 2 Diabetes. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=About%2038%20million%20Americans%20have,adults%20are%20also%20developing%20it.
- Heng-Chih Pan, Jui-Yi Chen, Hsing-Yu Chen. et al. (2024. Jan 4). Sodium-Glucose Cotransport Protein 2 Inhibitors in Patients With Type 2 Diabetes and Acute Kidney Disease. JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813460?resultClick=1
- Medscape (2024, Jan 6). Common Diabetes Pills also protect Kidneys. https://www.medscape.com/viewarticle/common-diabetes-pills-also-protect-kidneys-2024
- NIH (2022, Oct 24). Chronic Kidney Disease. https://www.ncbi.nlm.nih.gov/books/NBK535404/
