An Age of Sodium-Glucose Cotransporter-2 Inhibitor Priority: Are We Ready?
Abstract
Corresponding author: Ji A Seo https://orcid.org/0000-0002-1927-2618 Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea E-mail: [email protected] Over the past decade, the use of dipeptidyl peptidase-4 (DPP4) inhibitors in Korea has steadily increased, replacing sulfonylurea as the most commonly used add-on drug for metformin because of its low risk of hypoglycemia and its relatively better glucose-lowering effect among Asians [1,2]. However, DPP-4 inhibitors have not shown beneficial cardiovascular effects beyond safety in randomized controlled clinical trials among type 2 diabetes mellitus (T2DM) patients [3,4]. In contrast, followed by the striking results of the EMPA-REG OUTCOME study (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients) [5], a series of clinical trials demonstrated the protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors on cardiovascular and renal complications [6-8]. Thus, most updated treatment guidelines recommend SGLT2 inhibitors to be considered as the preferred choice for T2DM patients with atherosclerotic cardiovascular disease, heart failure, nephropathy, or multiple risk factors [9,10]; SGLT2 inhibitors are accordingly being used in an increasing number of Korean T2DM patients. Today, there is even a practical guide to help doctors who are not…
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