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Defining the Role of SGLT2 Inhibitors in Primary Care: Time to Think Differently

Marc Evans, Angharad R. Morgan, Steve Bain Orcid Logo, Sarah Davies, Umesh Dashora, Smeeta Sinha, Samuel Seidu, Dipesh C. Patel, Hannah Beba, W. David Strain

Diabetes Therapy, Volume: 13, Issue: 5, Pages: 889 - 911

Swansea University Author: Steve Bain Orcid Logo

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Abstract

Disease burden in people with diabetes is mainly driven by long-term complications such as cardiovascular disease, heart failure and chronic kidney disease. This is a consequence of the interconnection between the cardiovascular, renal and metabolic systems, through a continuous chain of events refe...

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Published in: Diabetes Therapy
ISSN: 1869-6953 1869-6961
Published: Springer Science and Business Media LLC 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59763
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Abstract: Disease burden in people with diabetes is mainly driven by long-term complications such as cardiovascular disease, heart failure and chronic kidney disease. This is a consequence of the interconnection between the cardiovascular, renal and metabolic systems, through a continuous chain of events referred to as ‘the cardiorenal metabolic continuum’. Increasing evidence suggests that sodium–glucose cotransporter 2 inhibitors (SGLT2is) have beneficial effects across all stages of the cardiorenal metabolic continuum, reducing morbidity and mortality in a wide range of individuals, from those with diabetes and multiple risk factors to those with established heart failure and chronic kidney disease, regardless of the presence of diabetes. Despite this robust evidence base, the complexity of label indications and misconceptions concerning potential side effects have resulted in a lack of clear understanding in primary care regarding the implementation of SGLT2is in clinical practice. With this in mind, we provide an overview of the clinical and economic benefits of SGLT2is across the cardiorenal metabolic continuum together with practical considerations in order to help address some of these concerns and clearly define the role of SGLT2is in primary care as a holistic outcomes-driven treatment with the potential to reduce disease burden across the cardiorenal metabolic spectrum.
Keywords: Cardiorenal metabolic continuum; Chronic kidney disease; Diabetes; Heart failure; SGLT2 inhibitors; Primary care
College: Swansea University Medical School
Funders: This work was supported by a grant from AstraZeneca in respect of medical writing and publication costs.
Issue: 5
Start Page: 889
End Page: 911