• Şahbender Koç.
• University of Health Sciences, Keçiören Education and Training Hospital, Ankara, Turkey.
• Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14794.

IntroductionPlasma osmolarity is maintained through various mechanisms. The osmolarity of the aqueous humor around the crystalline lens is correlated with plasma osmolarity. A vacuole can be formed in the lens upon changes in osmolarity. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) are new in the treatment of heart failure. They can cause osmotic diuresis but do not affect plasma osmolarity.ObjectiveIt is unclear if the presence or absence of lens vacuole changes can monitor diabetic heart failure and SGLT2i treatment efficacy.MethodsWeb of Science, PubMed and Scopus databases were searched for relevant articles about osmolarity, diabetes, transient receptor potential vanilloid channel, diabetic heart failure, lens vacuoles up to May 2021.Main MessageThe effect of SGLT2i on osmosis underlies its benefit to heart failure, but this in turn affects many other mechanisms. Failure to experience osmolarity changes will reduce the negative changes in terms of heart failure affected by osmolarity. A practical observable method is needed.ConclusionsThere is a possibility of using lens vacuoles in the follow-up of diabetic heart failure patients.© 2021 John Wiley & Sons Ltd.

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