Role of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus

Acta Diabetol. 2016 Dec;53(6):863-870. doi: 10.1007/s00592-016-0856-y. Epub 2016 Apr 1.

Abstract

In the last ten years, knowledge on pathophysiology of type 2 diabetes (T2DM) has significantly increased, with multiple failures (decreased incretin effect, increased lipolysis, increased glucagon secretion, neurotransmitters dysfunction) recognized as important contributors, together with decreased insulin secretion and reduced peripheral glucose uptake. As a consequence, the pharmacologic therapy of T2DM has been progressively enriched by several novel classes of drugs, trying to overcome these defects. The last, intriguing compounds come into the market are SGLT2 inhibitors, framing the kidney in a different scenario, not as site of a harmful disease complication, but rather as the means to correct hyperglycemia and fight the disease. This review aims to offer a short, updated overview of the role of these compounds in the treatment of T2DM, focusing on efficacy, ancillary albeit relevant clinical effects, safety, potential cardiovascular protection, positioning in common therapeutic algorithms.

Keywords: Blood pressure; Glucose toxicity; HbA1c; Renal tubule; SGLT2 inhibitors; Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / metabolism
  • Diabetes Mellitus, Type 2* / physiopathology
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Incretins / metabolism
  • Insulin / metabolism*
  • Insulin Secretion
  • Kidney* / drug effects
  • Kidney* / metabolism
  • Kidney* / physiopathology
  • Sodium-Glucose Transporter 2 Inhibitors
  • Sodium-Glucose Transporter 2* / metabolism
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Incretins
  • Insulin
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors