Sodium–glucose cotransporter 2 (SGLT2) inhibitors were initially developed for their glucose-lowering effects and have shown a modest glycaemic benefit in people with type 2 diabetes mellitus (T2DM). In the past decade, a series of large, robust clinical trials of these therapies have demonstrated striking beneficial effects for various care goals, transforming the chronic disease therapeutic landscape. Cardiovascular safety studies in people with T2DM demonstrated that SGLT2 inhibitors reduce cardiovascular death and hospitalization for heart failure. Subsequent trials in participants with heart failure with reduced or preserved left ventricular ejection fraction demonstrated that SGLT2 inhibitors have beneficial effects on heart failure outcomes. In dedicated kidney outcome studies, SGLT2 inhibitors reduced the incidence of kidney failure among participants with or without diabetes. Post hoc analyses have suggested a range of other benefits of these drugs in conditions as diverse as metabolic dysfunction-associated steatotic liver disease, kidney stone prevention and anaemia. SGLT2 inhibitors have a generally favourable adverse effect profile, although patient selection and medication counselling remain important. Concerted efforts are needed to better integrate these agents into routine care and support long-term medication adherence to close the gap between clinical trial outcomes and those achieved in the real world.

钠-葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂最初是因其降血糖作用而开发的，并已显示出对 2 型糖尿病 (T2DM) 患者的适度血糖益处。在过去的十年中，这些疗法的一系列大型、稳健的临床试验已经证明了对各种护理目标的显着有益效果，改变了慢性病的治疗格局。针对 T2DM 患者的心血管安全性研究表明，SGLT2 抑制剂可减少心血管死亡和心力衰竭住院率。随后对左心室射血分数降低或保留的心力衰竭参与者进行的试验表明，SGLT2 抑制剂对心力衰竭结局具有有益作用。在专门的肾脏结果研究中，SGLT2 抑制剂降低了患有或不患有糖尿病的参与者肾衰竭的发生率。事后分析表明，这些药物在代谢功能障碍相关的脂肪肝病、肾结石预防和贫血等多种疾病中具有一系列其他益处。尽管患者选择和药物咨询仍然很重要，但 SGLT2 抑制剂总体上具有良好的不良反应。需要共同努力，更好地将这些药物纳入日常护理中，并支持长期用药依从性，以缩小临床试验结果与现实世界中取得的结果之间的差距。