Sodium-Glucose Cotransporter 2 Inhibitors: A Case Study in Translational Research

Diabetes. 2019 Jun;68(6):1109-1120. doi: 10.2337/dbi18-0006.

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the most recently approved class of diabetes drugs. Unlike other agents, SGLT2 inhibitors act on the kidney to promote urinary glucose excretion. SGLT2 inhibitors provide multiple benefits, including decreased HbA1c, body weight, and blood pressure. These drugs have received special attention because they decrease the risk of major adverse cardiovascular events and slow progression of diabetic kidney disease (1-3). Balanced against these impressive benefits, the U.S. Food and Drug Administration-approved prescribing information describes a long list of side effects: genitourinary infections, ketoacidosis, bone fractures, amputations, acute kidney injury, perineal necrotizing fasciitis, and hyperkalemia. This review provides a physiological perspective to understanding the multiple actions of these drugs complemented by a clinical perspective toward balancing benefits and risks.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Blood Pressure
  • Body Weight
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Fasciitis, Necrotizing / chemically induced
  • Fractures, Bone / chemically induced
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperkalemia / chemically induced
  • Ketosis / chemically induced
  • Reproductive Tract Infections / etiology
  • Sodium-Glucose Transporter 2 / metabolism
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*
  • Translational Medical Research
  • Urinary Tract Infections / etiology
  • Weight Loss

Substances

  • Glycated Hemoglobin A
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • hemoglobin A1c protein, human