Recent Advances on SGLT 2 Inhibitors: Synthetic Approaches, Therapeutic Benefits, and Adverse Events

Diabetes mellitus comprises serious metabolic disorders currently affecting almost 500 million people globally – an estimate predicted to rise up to approximately 700 million by 2045. With time, permanently high blood sugar levels caused either by autoimmune destruction of pancreatic beta cells (type 1 diabetes) or peripheral insulin resistance (type 2 diabetes) may lead to cardiovascular complications and kidney damage, among other causes of high morbidity and mortality among diabetic patients. Sodium–glucose-linked transporter (SGLT2) inhibitors are the most recent class of antidiabetic drugs approved by regulatory authorities and have recently been associated with remarkable clinical outcomes in patients with diabetes and related comorbidities. This multidisciplinary review chapter covers the most recent and innovative synthetic approaches for the generation of gliflozin SGLT2 inhibitors, together with the newest results of clinical trials and real-world evidence studies, with special focus on the years of 2019 and 2020. Up-to-date data on glycemic control, cardioprotective, and renoprotective effects of SGLT2 inhibitors are herein explored, as well as common adverse events experienced by patients in the course of their treatment, both in the context of type 1 and type 2 diabetes.