SGLT-2 inhibitors in Heart Failure

In the last five years or so, there's been a huge growth in use of SGLT2 inhibitors in heart failure, largely because research has demonstrated and clinical trials have demonstrated again and again that these drugs really help people with heart failure. They help in a variety of mechanisms in terms of reducing hospitalizations and reducing heart failure related deaths. So whereas initially they were prescribed for people only with diabetes, actually the clinical studies found that the drugs also helped people with heart failure. So then it was used in patients with heart failure alone and again that effect was definitely seen and hence it's now being used in patients who just have heart failure and don't necessarily have diabetes. There's also more recent data coming out suggesting that it's possible that this drug may be useful for different types of heart failure as well. It's a really exciting time for SGLT2 inhibitors and a lot of heart failure patients are being prescribed them. It's important to note that there are some side effects, so I usually warn patients that there is a small chance, maybe 10% or less, of genital infections at the time of taking the drugs. So make sure they shake well or wipe properly when they're using in the first few weeks of starting an SGLT2 inhibitors. The other thing is sick day rules. If you're otherwise unwell, you should omit taking the SGLT2 inhibitor. Things like suffering with diarrhea and vomiting. If you've suffered with previous diabetic ketoacidosis, let's say you are a diabetic patient, then again it's really important to seek special advice from your doctor as the drug may not be appropriate for you.