{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:44:29Z","timestamp":1760060669824,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Office, College of Medicine and Health Sciences, United Arab Emirates University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The United Arab Emirates (UAE) faces a high burden of type 2 diabetes mellitus (T2DM) and its complications. While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have demonstrated cardiorenal benefits in clinical trials, real-world evidence on their association with calculated cardiovascular risk in Middle Eastern populations remains limited. This study evaluated the long-term real-world outcomes associated with SGLT2i use in Emirati patients with T2DM. Methods: We conducted a retrospective observational study of patients with T2DM initiated on SGLT2i (empagliflozin, dapagliflozin, or canagliflozin) at Tawam Hospital, UAE, between 1 January 2018 and 31 December 2018. Patients were followed for up to 5 years. Primary outcomes included changes in glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), and body mass index (BMI). A key secondary outcome was the change in 10-year atherosclerotic cardiovascular disease (ASCVD) risk, calculated using the ACC\/AHA Pooled Cohort Equations. Results: We included 185 patients (mean age 57 \u00b1 12 years, 56.2% female), with 107 (57.8%) receiving empagliflozin, 54 (29.2%) dapagliflozin, 11 (5.9%) canagliflozin, and 13 (7.0%) who switched between agents. Significant improvements were observed in HbA1c (8.7 \u00b1 1.8% to 8.2 \u00b1 1.9%, p &lt; 0.001), while eGFR showed preservation of renal function with an annual decline of 1.1 mL\/min\/1.73 m2. Among 120 patients eligible for ASCVD risk assessment (excluding 65 with established cardiovascular disease), the mean 10-year ASCVD risk decreased from 22.3 \u00b1 5.3% at baseline to 19.3 \u00b1 4.9% at 5 years (absolute reduction \u22123.0%, 95% CI \u22122.4 to \u22123.6%, p &lt; 0.001). Serious adverse events were rare, including acute kidney injury (1.1%) and fractures (1.6%). No episodes of diabetic ketoacidosis or severe hypoglycemia were observed. Conclusions: In this real-world cohort from the UAE, SGLT2 inhibitor use was associated with sustained glycemic control, preserved renal function, and lower calculated 10-year cardiovascular risk over 5 years. These observational findings, noted in the context of comprehensive risk factor management, support the potential benefits of SGLT2i in high-risk Middle Eastern patients with T2DM, though prospective controlled studies are needed to confirm causality.<\/jats:p>","DOI":"10.3390\/jcm14186365","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T08:43:54Z","timestamp":1757493834000},"page":"6365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Cardiorenal Benefits of Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Type 2 Diabetes Mellitus: A Real-World Single-Center Experience"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-8931","authenticated-orcid":false,"given":"Adnan","family":"Agha","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bachar","family":"Afandi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tawam Hospital, Al Ain P.O. Box 15258, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed","family":"AlKaabi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tawam Hospital, Al Ain P.O. Box 15258, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7364-9233","authenticated-orcid":false,"given":"Naser Abdulla Naser Salem","family":"Alshkeili","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tawam Hospital, Al Ain P.O. Box 15258, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Ali Alsharoon","family":"Alshemeili","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tawam Hospital, Al Ain P.O. Box 15258, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Mohammed Al","family":"Ghaithi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Mohammed Hareb","family":"Alsaadi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2477-0408","authenticated-orcid":false,"given":"Juma","family":"Alkaabi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition","volume":"157","author":"Saeedi","year":"2019","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_2","unstructured":"International Diabetes Federation (2021). IDF Diabetes Atlas, International Diabetes Federation. [10th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sulaiman, N., Albadawi, S., Abusnana, S., Mairghani, M., Hussein, A., Al Awadi, F., Madani, A., Zimmet, P., and Shaw, J. (2018). High prevalence of diabetes among migrants in the United Arab Emirates using a cross-sectional survey. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-24312-3"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.pcd.2014.01.002","article-title":"Ethnicity is an independent risk indicator when estimating diabetes risk with FINDRISC scores: A cross sectional study comparing immigrants from the Middle East and native Swedes","volume":"8","author":"Bennet","year":"2014","journal-title":"Prim. Care Diabetes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"15019","DOI":"10.1038\/nrdp.2015.19","article-title":"Type 2 diabetes mellitus","volume":"1","author":"DeFronzo","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Emerging Risk Factors Collaboration (2010). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of 102 prospective studies. Lancet, 375, 2215\u20132222.","DOI":"10.1016\/S0140-6736(10)60484-9"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1258\/shorts.2012.011150","article-title":"Epidemiology of end-stage renal disease in the countries of the Gulf Cooperation Council: A systematic review","volume":"3","author":"Hassanien","year":"2012","journal-title":"JRSM Short Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s00125-016-4157-3","article-title":"Targeting renal glucose reabsorption to treat hyperglycaemia: The pleiotropic effects of SGLT2 inhibition","volume":"60","author":"Vallon","year":"2017","journal-title":"Diabetologia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1056\/NEJMoa1611925","article-title":"Canagliflozin and cardiovascular and renal events in type 2 diabetes","volume":"377","author":"Neal","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1056\/NEJMoa1812389","article-title":"Dapagliflozin and cardiovascular outcomes in type 2 diabetes","volume":"380","author":"Wiviott","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1007\/s00125-018-4670-7","article-title":"SGLT2 inhibitors and mechanisms of cardiovascular benefit: A state-of-the-art review","volume":"61","author":"Verma","year":"2018","journal-title":"Diabetologia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jacc.2019.11.031","article-title":"Mechanisms of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC state-of-the-art review","volume":"75","author":"Zelniker","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1007\/s00392-024-02386-6","article-title":"Sodium glucose cotransporter 2 inhibitors with cardiac arrhythmias in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized placebo-controlled trials","volume":"113","author":"Xu","year":"2024","journal-title":"Clin. Res. Cardiol."},{"key":"ref_15","unstructured":"American Diabetes Association (2023). Standards of Medical Care in Diabetes-2023. Diabetes Care, 46, S1\u2013S267."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/eurheartj\/ehz486","article-title":"European Society of Cardiology (ESC) Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD","volume":"41","author":"Cosentino","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2628","DOI":"10.1016\/j.jacc.2018.03.009","article-title":"Cardiovascular events associated with SGLT-2 inhibitors versus other glucose-lowering drugs: The CVD-REAL 2 study","volume":"71","author":"Kosiborod","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000427","DOI":"10.1136\/bmjdrc-2017-000427","article-title":"Clinical profiles, comorbidities and complications of type 2 diabetes mellitus in patients from United Arab Emirates","volume":"5","author":"Jelinek","year":"2017","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/ejcn.2014.251","article-title":"Vitamin D supplementation in obese type 2 diabetes subjects in Ajman, UAE: A randomized controlled double-blinded clinical trial","volume":"69","author":"Sadiya","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jsbmb.2016.02.007","article-title":"Vitamin D deficiency: A single centre analysis of patients from 136 countries","volume":"164","author":"Haq","year":"2016","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"398","DOI":"10.2215\/CJN.05280517","article-title":"Kidney biomarkers and decline in eGFR in patients with type 2 diabetes","volume":"13","author":"Garlo","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.2337\/dc16-1974","article-title":"Type 2 diabetes in the real world: The elusive nature of glycemic control","volume":"40","author":"Edelman","year":"2017","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1001\/jama.281.21.2005","article-title":"Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: Progressive requirement for multiple therapies (UKPDS 49)","volume":"281","author":"Turner","year":"1999","journal-title":"JAMA"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6365\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:42:46Z","timestamp":1760035366000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/18\/6365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":23,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcm14186365"],"URL":"https:\/\/doi.org\/10.3390\/jcm14186365","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,9,9]]}}}