Abstract

Type 2 diabetes mellitus was a complex metabolic disorder associated with a high burden of cardiovascular and renal 
complications, which remained the leading causes of morbidity and mortality despite advances in glycemic control 
strategies. Sodium glucose cotransporter 2 inhibitors emerged as a novel class of antidiabetic agents that extended 
therapeutic benefits beyond glucose lowering, particularly in cardiovascular and renal protection. The purpose of 
this review was to critically examine the biochemical, physiological, and clinical mechanisms through which SGLT2 
inhibitors conferred cardiorenal benefits in individuals with Type 2 diabetes. A narrative literature synthesis of 
experimental studies, mechanistic research, and large-scale randomized clinical trials was employed to develop this 
review. Evidence indicated that SGLT2 inhibitors exerted multifaceted protective effects, including modulation of 
renal hemodynamics, improvement in myocardial energetics, reduction of systemic inflammation, and favorable 
alterations in metabolic and neurohormonal pathways. Clinical trials consistently demonstrated significant 
reductions in heart failure hospitalization, progression of chronic kidney disease, and cardiovascular mortality. 
SGLT2 inhibitors represented a paradigm shift in the management of Type 2 diabetes by addressing both metabolic 
control and end-organ protection. Their integration into routine clinical practice was strongly supported, with 
continued research warranted to refine patient selection and explore long-term outcomes across diverse populations.