Among the complications of diabetes, cardiovascular events and cardiac insufficiency are considered two of the most important causes of death. Experimental and clinical evidence supports the effectiveness of SGLT2i for improving cardiac dysfunction. SGLT2i treatment benefits metabolism, microcirculation, mitochondrial function, fibrosis, oxidative stress, endoplasmic reticulum stress, programmed cell death, autophagy, and the intestinal flora, which are involved in diabetic cardiomyopathy. This review summarizes the current knowledge of the mechanisms of SGLT2i for the treatment of diabetic cardiomyopathy. Graphical Abstract

Thirty years ago, the prevalence of diabetic patients was only onefourth the current prevalence. In fact, the current number of diabetic patients has soared to 1 diabetic patient in every 11 people globally. 1 Moreover, diabetes has become the ninth leading cause of death worldwide. According to statistics from the World Health Organization, as of 2000, the number of diabetes patients worldwide had exceeded 170 million, and it is still increasing at an extremely fast rate. It is predicted that the number of diabetic-related deaths will double between 2000 and 2030. 2 Among diabetic patients, type 2 diabetes mellitus (T2DM) is most common, accounting for approximately 90% of adult patients with diabetes. Unlike type 1 diabetes mellitus (T1DM), which is an autoimmune disease, the