Diabetes mellitus (DM) is a major
chronic disease with ever-increasing prevalence and a variety of serious complications for persons with DM, such as cardiovascular and/or renal complications. New
glucose-lowering
therapies like
DPP-4 inhibitors,
GLP-1 receptor agonists, and
SGLT-2 inhibitors have undergone cardiovascular outcome trials (CVOTs) for
type 2 diabetes (T2DM), as by the guidance of the FDA. However, CVOTs for
type 1 diabetes (T1DM) are generally lacking. Both, persons with T1DM and T2DM, are burdened with a high incidence of cardiovascular and renal disease such as atherosclerotic cardiovascular disease (ASCVD) and
diabetic kidney disease (DKD). Although pathologies of the two types of diabetes cannot be compared, similar mechanisms and risk factors like sex, hyperglycaemia,
hypertension, endothelial damage and (background)
inflammation have been identified in the development of CVD and DKD in T1DM and T2DM. Recent CVOTs in T2DM demonstrated that
SGLT-2 inhibitors, besides exerting a
glucose-lowering effect, have beneficial effects on cardiovascular and renal mechanisms. These mechanisms are reviewed in detail in this manuscript and evaluated for possible transferability to, and thus efficacy in, T1DM. Our review of current literature suggests that
SGLT-2 inhibitors have cardioprotective benefits beyond their
glucose-lowering effects. As this mainly has been observed in CVOTs in T2DM, further investigation in the adjunctive
therapy for
type 1 diabetes is suggested.