Practical considerations for the use of SGLT‐2 inhibitors in the Asia–Pacific countries—An expert consensus statement

Recent clinical studies have demonstrated the effectiveness of SGLT‐2 inhibitors in reducing the risks of cardiovascular and renal events in both patients with and without type 2 diabetes mellitus. Consequently, many international guidelines have begun advocating for the use of SGLT‐2 inhibitors for...

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Bibliographic Details
Published in:Nephrology (Carlton, Vic.) Vic.), 2023-08, Vol.28 (8), p.415-424
Main Authors: Liew, Adrian, Lydia, Aida, Matawaran, Bien J., Susantitaphong, Paweena, Tran, Huong Thi Bich, Lim, Lee Ling
Format: Article
Language:English
Subjects:
acute kidney injury
Aged
Blood Glucose
chronic kidney disease
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Humans
Hypoglycemic Agents - adverse effects
Ketoacidosis
ketosis
Patients
Risk Factors
Sodium-Glucose Transporter 2 Inhibitors - adverse effects
sodium‐glucose transporter 2 inhibitors
urinary tract infections
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Summary:Recent clinical studies have demonstrated the effectiveness of SGLT‐2 inhibitors in reducing the risks of cardiovascular and renal events in both patients with and without type 2 diabetes mellitus. Consequently, many international guidelines have begun advocating for the use of SGLT‐2 inhibitors for the purpose of organ protection rather than as simply a glucose‐lowering agent. However, despite the consistent clinical benefits and available strong guideline recommendations, the utilization of SGLT‐2 inhibitors have been unexpectedly low in many countries, a trend which is much more noticeable in low resource settings. Unfamiliarity with the recent focus in their organ protective role and clinical indications; concerns with potential adverse effects of SGLT‐2 inhibitors, including acute kidney injury, genitourinary infections, euglycemic ketoacidosis; and their safety profile in elderly populations have been identified as deterring factors to their more widespread use. This review serves as a practical guide to clinicians managing patients who could benefit from SGLT‐2 inhibitors treatment and instill greater confidence in the initiation of these drugs, with the aim of optimizing their utilization rates in high‐risk populations. Summary at a Glance This paper provides a summary of indications for SGLT‐2 inhibitor therapy in appropriate patient populations based on current available clinical evidence. In addition, it provides an expert consensus on practical suggestions in mitigating the clinical issues associated with SGLT‐2 inhibitor use. In doing so, it aims to increase the familiarity and confidence of treating physicians in increasing the utilization of SGLT‐2 inhibitors in patients who need them.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.14167