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Sodium–glucose cotransporter-2 inhibitors in patients without diabetes
Elise Fryml and Matthew B. Lanktree
CMAJ May 01, 2023 195 (17) E619; DOI: https://doi.org/10.1503/cmaj.221691
Elise Fryml
Department of Medicine (Fryml), University of British Columbia, Vancouver, BC; Departments of Medicine, and Health Research Methodology, Evidence, and Impact (Lanktree), McMaster University, Hamilton, Ont.
MD MScMatthew B. Lanktree
Department of Medicine (Fryml), University of British Columbia, Vancouver, BC; Departments of Medicine, and Health Research Methodology, Evidence, and Impact (Lanktree), McMaster University, Hamilton, Ont.
MD PhDIn this issue
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Sodium–glucose cotransporter-2 inhibitors in patients without diabetes
Elise Fryml, Matthew B. Lanktree
CMAJ May 2023, 195 (17) E619; DOI: 10.1503/cmaj.221691
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- In patients without diabetes, sodium–glucose cotransporter-2 (SGLT2) inhibitors (or “flozins”) should be considered for moderate chronic kidney disease or clinical heart failure regardless of ejection fraction
- Benefits of SGLT2 inhibitors include improved blood pressure, albuminuria and weight loss
- Testing eGFR is not required after starting SGLT2 inhibitors except in patients at risk of volume depletion (i.e., orthostatic hypotension, high-dose diuretics)5
- Women are 2–3 times more likely than men to have a genital mycotic infection while taking SGLT2 inhibitors
- No cases of severe hypoglycemia or euglycemic diabetic ketoacidosis were reported in SGLT2 inhibitor clinical trials that included 5877 patients without diabetes2
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