A Call for a Modern Satyagraha Against Metabolic Syndrome
, 4, 5, 6
Abstract
Objective: In 1923, while India was engaged in the Flag Satyagraha movement for independence, the medical community witnessed the discovery of insulin and the early recognition of metabolic syndrome (MetS) by Swedish physician Eskil Kylin. This article draws parallels between the historical Satyagraha movement and the current fight against MetS, advocating for a comprehensive and integrated approach to managing this syndrome. We explore the multifaceted role of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in managing MetS, emphasizing their cardioprotective and renoprotective benefits. Materials and methods: A detailed review of existing literature on MetS, its definitions, prevalence, and management strategies was conducted. The therapeutic potential of SGLT2i was examined through a meta-analysis of randomized controlled trials (RCTs) to assess their impact on key components of MetS, including fasting plasma glucose, waist circumference (WC), blood pressure, body weight, and uric acid levels. Results and conclusions: SGLT2is, including empagliflozin, dapagliflozin, and canagliflozin, demonstrated significant efficacy in improving several components of MetS. Notably, these agents reduced fasting plasma glucose by up to 30.02 mg/dL and WC by 1.28 cm, while also providing modest reductions in systolic blood pressure and body weight. Additionally, SGLT2is were associated with significant reductions in uric acid levels, contributing to their renoprotective effects. Despite the minimal impact on high-density lipoprotein (HDL) cholesterol levels, SGLT2is showed broad cardiometabolic benefits, including anti-inflammatory effects and modulation of sympathetic nervous system activity. Public health initiatives must also prioritize lifestyle modifications and early detection to curb the rising prevalence of this condition.
Keywords: metabolic syndromeSGLT2 inhibitorscardioprotectionrenoprotectionpublic healthdiabetescardiovascular diseasehypertensioninsulin resistance
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