Efeitos cardioprotetores e nefroprotetores dos inibidores de SGLT2 em pacientes com Diabetes mellitus tipo 2

Abstract

Type 2 Diabetes Mellitus (T2DM) has become a major global public health problem, requiring strategies that go beyond isolated glycemic control to mitigate multisystem complications, since chronic hyperglycemia predisposes individuals to severe vascular damage, resulting in high morbidity and mortality due to cardiovascular and renal outcomes. In this context, sodium–glucose cotransporter 2 inhibitors (SGLT2 inhibitors) have emerged as an innovative therapeutic class that redefines the treatment paradigm by providing metabolic benefits and direct organ protection. This study conducted an integrative literature review to analyze the cardioprotective and nephroprotective effects of SGLT2 inhibitors in patients with T2DM, comparing their efficacy and safety with other therapeutic options. The search was carried out in the PubMed, SciELO, and Google Scholar databases, selecting 63 publications published between 2010 and 2025, including randomized clinical trials (RCTs), meta-analyses, and experimental studies. A qualitative and descriptive analysis allowed data tabulation and categorization of results according to physiological mechanisms and observed clinical outcomes. The findings demonstrate that SGLT2 inhibitors promote a reduction in glycated hemoglobin (HbA1c) when used as an adjunct therapy, as well as a reduction in body weight, featuring a low risk of hypoglycemia due to their insulin-independent mechanism. In the renal context, studies confirmed a significant reduction in the progression of chronic kidney disease and albuminuria through the restoration of tubuloglomerular feedback. Regarding cardiovascular protection, a consistent decrease in hospitalizations for heart failure and cardiovascular mortality was observed, driven by both hemodynamic and metabolic effects. Additionally, this drug class showed a favorable safety profile, although it was associated with an increased incidence of genitourinary infections as a consequence of induced glycosuria. It is concluded that SGLT2 inhibitors represent a crucial advancement in clinical pharmacology, establishing themselves as a key strategy for the preservation of cardiorenal function and the improvement of the quality of life for patients with T2DM.