A lot of attention has been focused on a new class of drug for diabetics called sodium glucose co-transporter inhibitors (SGLT-2i). It alters the way glucose and sodium are treated in the kidneys and for the diabetic can lead to increased loss of sugar and water through urine. A large relatively recent study called EMPA-REG looked at this medication for diabetics. To everyone’s surprise, the study started to show improved outcomes that were just not expected. There appeared to be a decrease in overall mortality, a reduction in heart failure and even a reduction in progression to renal failure. The drug leads to decreased blood sugar levels hence improving glucose control but also lowers total body water which appears very important in reduction of risk in heart failure and possibly activation of the sympathetic nervous system. This is particularly the case for the type of heart failure which we see in diabetics which we call preserved left ventricular function failure or shortness of breath with a heart that appears to work well. SGLT-2i is showing promise in terms of reducing hospitalisation and improving mortality in diabetics. There is now more and more research looking into this class of drug. The drug most representative of the class is called Empaglifloxin and I am sure this will be used more and more on a routine basis for diabetics to help manage their sugar levels and #hearthealth. #diabetes #heartattack

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