New research, however, is pointing out the drug’s stellar track record among heart failure patients, prompting the FDA to approve it for that purpose in February 2022. Lots of type 2 diabetic patients will develop cardiovascular issues including heart failure, and researchers couldn’t help noticing that SGLT2s were improving their patients’ cardiovascular outcomes.

Basically, heart failure occurs when the heart stops pumping blood efficiently. Multiple organs and body functions are put at risk, and patients with this condition could die suddenly of heart attacks or other complications. Doctors will often prescribe ACE inhibitors and related medicines like beta blockers, but until recently SGLT2s weren’t seen as part of the armamentarium.

The FDA’s approval was informed by research which indicated which proved that:

• 90 days into the study timeframe, heart failure patients who received an SGLT2 were doing much better than patients who took a placebo.
• Many patients who took an SGLT2 had a reduction in body weight.
• There were far fewer deaths in an SGLT2 group than in a placebo group.

This is good news because very few drugs can significantly improve heart function and heart failure symptoms so long after hospitalisation. The SGLT2s were also considered extremely safe and there were very few adverse reactions.

HOW DO SGLTs IMPROVE HEART FAILURE?

Firstly, SGLTs induce patients to urinate more, as part of the process of sodium (salt) excretion. High salt levels have long been connected to heart failure. SGLT2s improve and stabilise the heart’s preload and afterload functions, helping it to pump blood more effectively. SGLT2s also stimulate the production of ketones in the liver. Ketones are noted for their ability to improve hearts that are failing.