PMID- 29226041
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 9
IP  - 10
DP  - 2017 Oct 5
TI  - Dapagliflozin: Cardiovascular Safety and Benefits in Type 2 Diabetes Mellitus.
PG  - e1751
LID - 10.7759/cureus.1751 [doi]
LID - e1751
AB  - Sodium-glucose co-transporter 2 inhibitors (SGLT2is) such as dapagliflozin, 
      canagliflozin, and empagliflozin, are a promising new therapy in the treatment of 
      type 2 diabetes mellitus (T2DM). SGLT2is can effectively reduce hyperglycemia 
      thus improving glycemic control and they offer some beneficial effects on the 
      cardiovascular (CV) system which can benefit patients with heart failure in 
      addition toT2DM. The United States Food and Drug Administration requires new 
      diabetes mellitus therapies to show a CV safety profile. Empagliflozin was the 
      first SGLT2i that, when added to the standard of care for patients withT2DM at 
      high risk for CV events, showed improved CV outcomes including reduced deaths 
      from CV causes. Evidence also exists in favor of dapagliflozin for use in 
      patients with T2DM with CV risk factors and heart failure. This review focuses on 
      the effects, safety, and benefits of dapagliflozin on the CV system. Clinical 
      trials have shown that dapagliflozin improves glycemic control without variation. 
      It is safe and well-tolerated in the general population including older patients 
      and those with high-risk CV factors or preexisting CV disease. There may be a 
      renal protective role by an unknown mechanism. Dapagliflozin also lowers blood 
      pressure due to its natriuresis effect. It improves levels of visceral fat and 
      reduces body weight, and thus ameliorates metabolic syndrome. Dapagliflozin 
      reduces oxidative stress and may delay atherosclerosis. Recent findings indicate 
      SGLT2is may also reduce the atrial natriuretic peptide levels. Additional trials 
      are required to validate these benefits and further evaluate if these are class 
      effects. Trials such as DECLARE-TIMI58 are ongoing to evaluate the CV outcomes of 
      dapagliflozin. More research is needed to design better antihyperglycemic regimes 
      with clinical benefits in addition to good glycemic control.
FAU - Saleem, Fatima
AU  - Saleem F
AD  - Internal medicine, King Edward Medical University Lahore, Pakistan.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20171005
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC5716679
OTO - NOTNLM
OT  - cardiovascular
OT  - dapagliflozin
OT  - diabetes mellitus
OT  - sglt2 inhibitors
OT  - sodium-glucose co-transporter 2 inhibitors
COIS- The authors have declared that no competing interests exist.
EDAT- 2017/12/12 06:00
MHDA- 2017/12/12 06:01
PMCR- 2017/10/05
CRDT- 2017/12/12 06:00
PHST- 2017/12/12 06:00 [entrez]
PHST- 2017/12/12 06:00 [pubmed]
PHST- 2017/12/12 06:01 [medline]
PHST- 2017/10/05 00:00 [pmc-release]
AID - 10.7759/cureus.1751 [doi]
PST - epublish
SO  - Cureus. 2017 Oct 5;9(10):e1751. doi: 10.7759/cureus.1751.