What is the primary therapeutic action of SGLT-2 inhibitors?

Rationale: A. They promoting renal excretion of sodium and glucose: SGLT-2 inhibitors block the sodium-glucose co-transporter in the proximal renal tubules, reducing glucose reabsorption and increasing urinary glucose excretion. This leads to lower blood glucose levels and mild natriuresis, which also contributes to blood pressure reduction. B. They reduce hospitalizations by decreasing blood glucose levels through increasing insulin through the pancreas: SGLT-2 inhibitors do not act on the pancreas or increase insulin secretion. Their glucose-lowering effect comes from preventing renal reabsorption of glucose rather than stimulating insulin production. C. They increase the cardiac output by strengthening heart contractions: Although SGLT-2 inhibitors have shown cardiovascular benefits, they do so through mechanisms such as osmotic diuresis and reduced cardiac workload, not by increasing cardiac output directly. D. They decrease blood pressure by vasodilating peripheral vessels: While SGLT-2 inhibitors may lower blood pressure modestly, the mechanism is not through vasodilation. Instead, it is primarily related to osmotic diuresis and sodium loss, which reduce intravascular volume.