PMID- 37998523
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231127
IS  - 2308-3425 (Electronic)
IS  - 2308-3425 (Linking)
VI  - 10
IP  - 11
DP  - 2023 Nov 16
TI  - The Ketogenic Effect of SGLT-2 Inhibitors-Beneficial or Harmful?
LID - 10.3390/jcdd10110465 [doi]
LID - 465
AB  - Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, also called gliflozins or 
      flozins, are a class of drugs that have been increasingly used in the management 
      of type 2 diabetes mellitus (T2DM) due to their glucose-lowering, cardiovascular 
      (CV), and renal positive effects. However, recent studies suggest that SGLT-2 
      inhibitors might also have a ketogenic effect, increasing ketone body production. 
      While this can be beneficial for some patients, it may also result in several 
      potential unfavorable effects, such as decreased bone mineral density, 
      infections, and ketoacidosis, among others. Due to the intricate and multifaceted 
      impact caused by SGLT-2 inhibitors, this initially anti-diabetic class of 
      medications has been effectively used to treat both patients with chronic kidney 
      disease (CKD) and those with heart failure (HF). Additionally, their therapeutic 
      potential appears to extend beyond the currently investigated conditions. The 
      objective of this review article is to present a thorough summary of the latest 
      research on the mechanism of action of SGLT-2 inhibitors, their ketogenesis, and 
      their potential synergy with the ketogenic diet for managing diabetes. The 
      article particularly discusses the benefits and risks of combining SGLT-2 
      inhibitors with the ketogenic diet and their clinical applications and compares 
      them with other anti-diabetic agents in terms of ketogenic effects. It also 
      explores future directions regarding the ketogenic effects of SGLT-2 inhibitors.
FAU - Koutentakis, Michail
AU  - Koutentakis M
AUID- ORCID: 0009-0005-2934-2041
AD  - 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 
      02-097 Warsaw, Poland.
FAU - Kucinski, Jakub
AU  - Kucinski J
AUID- ORCID: 0000-0002-1331-8339
AD  - Central Clinical Hospital, Medical University of Warsaw, Banacha 1A, 02-097 
      Warsaw, Poland.
FAU - Swieczkowski, Damian
AU  - Swieczkowski D
AUID- ORCID: 0000-0002-5648-4652
AD  - Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, 
      80-416 Gdansk, Poland.
FAU - Surma, Stanislaw
AU  - Surma S
AUID- ORCID: 0000-0001-8073-6664
AD  - Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 
      Katowice, Poland.
FAU - Filipiak, Krzysztof J
AU  - Filipiak KJ
AUID- ORCID: 0000-0002-6563-0877
AD  - Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy, 00-001 
      Warsaw, Poland.
AD  - Department of Hypertensiology, Angiology and Internal Medicine, Poznan University 
      of Medical Sciences, 61-848 Poznan, Poland.
FAU - Gasecka, Aleksandra
AU  - Gasecka A
AUID- ORCID: 0000-0001-5083-7587
AD  - 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 
      02-097 Warsaw, Poland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231116
PL  - Switzerland
TA  - J Cardiovasc Dev Dis
JT  - Journal of cardiovascular development and disease
JID - 101651414
PMC - PMC10672595
OTO - NOTNLM
OT  - SGLT-2 inhibitors (gliflozins)
OT  - T2DM
OT  - benefits
OT  - cardiovascular
OT  - heart failure
OT  - infections
OT  - ketogenesis
OT  - ketogenic diet
OT  - kidney disease
OT  - risks
COIS- The funders had no role in the design of the study; in the collection, analyses, 
      or interpretation of data; in the writing of the manuscript; or in the decision 
      to publish the results.
EDAT- 2023/11/24 12:41
MHDA- 2023/11/24 12:42
PMCR- 2023/11/16
CRDT- 2023/11/24 09:36
PHST- 2023/10/04 00:00 [received]
PHST- 2023/11/09 00:00 [revised]
PHST- 2023/11/14 00:00 [accepted]
PHST- 2023/11/24 12:42 [medline]
PHST- 2023/11/24 12:41 [pubmed]
PHST- 2023/11/24 09:36 [entrez]
PHST- 2023/11/16 00:00 [pmc-release]
AID - jcdd10110465 [pii]
AID - jcdd-10-00465 [pii]
AID - 10.3390/jcdd10110465 [doi]
PST - epublish
SO  - J Cardiovasc Dev Dis. 2023 Nov 16;10(11):465. doi: 10.3390/jcdd10110465.