Abstract
Type 2 diabetes mellitus affects nearly 7% of the world’s population and is a significant contributor to the development of cardiovascular disease and heart failure. Historically, the pharmacologic therapy of cardiovascular disease has centered around blood pressure control, insulin and cholesterol management, the inhibition of the renin–angiotensin system, and catecholamine blockade. Recent evidence suggests that sodium–glucose cotransporter 2 (SGLT-2) inhibitors provide significant cardiovascular protection to patients with and without diabetes. The use of SGLT-2 inhibitors is associated with significant changes to serum biomarkers of cardiac function. In this narrative review, we summarize how biomarkers reflect physiologic aspects of cardiovascular function and how these are affected by the use of SGLT-2 inhibitors. © 2025 by the authors.