Cardiovascular Benefits and Pharmacological Mechanisms of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 2 Diabetes Mellitus: A Narrative Review
DOI:
https://doi.org/10.70749/ijbr.v4i2.2909Keywords:
Type 2 Diabetes Mellitus, SGLT2 Inhibitors, GLP-1 Receptor Agonists, Cardiovascular Disease, MACE, Heart Failure, Chronic Kidney Disease, Cardiorenal Protection.Abstract
Type 2 diabetes mellitus (T2DM), caused by hyperglycemia, insulin resistance, inflammation, oxidative stress, and endothelial dysfunction, leads to cardiovascular morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are classes of therapeutic agents that have shown cardiovascular effects on top of glycemic regulation. In this narrative review, existing evidence on pharmacological mechanisms and cardiovascular outcome data of the two drug classes are synthesized. The main effects of SGLT2 inhibitors are cardioprotective by hemodynamic and natriuretic mechanisms, enhanced myocardial energetics, and renal protection, and strong decreases in heart failure hospitalization and chronic kidney disease progression. Conversely, GLP-1 receptor agonists have anti-atherosclerotic and anti-inflammatory properties, which reduce major adverse cardiovascular events and stroke to a significant degree. Comparative analysis points to complementary processes and phenotype-specific advantages. Incorporation of these agents into modern management of T2DM is a paradigm shift in outcomes-based cardiometabolic care. There are also research gaps and future therapeutic implications.
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