A Review of the Proposed Mechanistic Actions of Sodium Glucose Cotransporter-2 Inhibitors in the Treatment of Heart Failure

Diabetes mellitus is a well-known risk factor for heart failure, and the reasons why are well understood. The incidence of diabetes mellitus is continuing to rise, posing a major concern in the medical world. The comorbidities associated with diabetes mellitus create a major hindrance on daily living, and promote the development of a plethora of other diseases. It is known that by controlling modifiable risk factors, such as glycemic control and body mass index, patients achieve more favorable outcomes. But, this is not always realistic and controlling modifiable risk factors should be balanced with a pharmacologic option. A relatively new drug class, which acts as an inhibitor of the sodium glucose cotransporter-2 receptor, has shown favorable outcomes in the treatment of heart failure associated with diabetes. However, the mechanism of action of this new drug class is not fully understood. There are several different proposed mechanisms of action for how sodium glucose cotransporter-2 inhibitors work in regards to the treatment of heart failure. This review will elaborate on those proposed mechanisms of action and offer insight into future implications of this relatively new drug class.