Table 1 Clinical effects and risks of SGLT2 inhibitors

1. Effect on glycemic

 A.The value of HbA1c level reduced approximately 0.7–1.0%

 B.Lower fasting plasma glucose, about 1.2 mmol/L

 C.Improved beta cell function

 D.Improve glucotoxicity

 E.Improved insulin sensitivity

 F.Increased endogenous glucose production

 G.Reduced insulin resistance

2. Effects on lipids

 A.Increased HDL, LDL and apolipoprotein

 B.Does not alter the concentration of LDL-C, but decreases small, dense LDL-C and increases large buoyant LDL-C

 C.Increased total cholesterol

 D.Lower triglyceride levels

 E.Lead to increased adiponectin

3. Weight

 A.Decreased waist circumference, subcutaneous adipose tissue, and visceral adipose tissue

 B.Increased glucagon secretion

 C.Weight loss of about 2–4 kg

4. Cardiovascular effects

 A.Reduced systolic blood pressure

 B.Improve inflammation and oxidative stress

 C.Improve vascular function

 D.Reduce cardiac preload

 E.Decreased left ventricular mass index

 F.Decreased NT-proBNP concentration

 G.Improve natriuresis

 H.Reduces pathological cardiomyocyte stiffness

 I.Lead to osmotic diuresis

 J.Increase hematocrit

 K.Lung fluid volume improved

 L.Improves diastolic function

 M.Improve cardiac remodeling

 N.Reduce ischemia–reperfusion injury

5. Effects on fibrosis markers

 A.Decreased Mac-2 binding protein

 B.FIB-4 index decreased

 C.Significantly lower NAFIC scores

6. Liver function improvement

 A.Reduced fatty liver index

 B.Decreased serum alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase levels

 C.Proton density fat fraction decreased

7. Effects on the kidneys

 A.Reducing vascular volume

 B.Reduce blood uric acid levels

 C.Reduced proteinuria

 D.Stabilize eGFR

 E.Improve urinary albumin/creatinine ratio

 F.Reduced kidney disease progression

 G.Improve natriuresis

8. SGLT2 inhibitors may reduce bone density

9. Effects on inflammatory factors

 A.Decreses soluble dipeptidyl peptidase levels

 B.Decreases ICAM-1, VCAM-1, TNF-α and IL-6

10. Oxidative stress

 A.Reduce H₂O₂, GSH, lipid peroxide

 B.Prevent PKGIα oxidation

11. Effect on anemia

 A.Decrease hepcidin levels

 B.Improve erythropoiesis

 C.Increase hemoglobin levels

 Cardiovascular: heart failure and hospitalization for heart failure, cardiovascular death, atrial fibrillation

Hypoglycemia

Hypotension

 All-cause mortality

Sarcopenia

 Anemia

Acute kidney injury

 Nonalcoholic fatty liver

Diabetic ketoacidosis

 Renal protection: diabetic kidney disease, chronic kidney disease, end-stage renal disease, kidney failure, kidney death

Genital or urinary tract infection

Dehydration

Hypovolemia

Indeterminate ameliorated events

Osmotic diuresis

 Nonfatal myocardial infarction

Amputation

 Non-fatal stroke

Fracture