Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes

Yoojin Kim, Ambika R BabuDivision of Endocrinology, John Stroger Jr Hospital of Cook County and Rush University, Chicago, IL, USABackground: The kidney plays an important role in glucose metabolism, and has been considered a target for therapeutic intervention. The sodium-glucose cotransporter type...

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Autores principales:	Kim Y, Babu AR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/36e89783c9db45c0975ec77d8c5db5b5
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spelling	oai:doaj.org-article:36e89783c9db45c0975ec77d8c5db5b52021-12-02T02:15:18ZClinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes1178-7007https://doaj.org/article/36e89783c9db45c0975ec77d8c5db5b52012-08-01T00:00:00Zhttp://www.dovepress.com/nbspclinical-potential-of-sodium-glucose-cotransporter-2-inhibitors-in-a10872https://doaj.org/toc/1178-7007Yoojin Kim, Ambika R BabuDivision of Endocrinology, John Stroger Jr Hospital of Cook County and Rush University, Chicago, IL, USABackground: The kidney plays an important role in glucose metabolism, and has been considered a target for therapeutic intervention. The sodium-glucose cotransporter type 2 (SGLT2) mediates most of the glucose reabsorption from the proximal renal tubule. Inhibition of SGLT2 leads to glucosuria and provides a unique mechanism to lower elevated blood glucose levels in diabetes. The purpose of this review is to explore the physiology of SGLT2 and discuss several SGLT2 inhibitors which have clinical data in patients with type 2 diabetes.Methods: We performed a PubMed search using the terms &quot;SGLT2&quot; and &quot;SGLT2 inhibitor&quot; through April 10, 2012. Published articles, press releases, and abstracts presented at national and international meetings were considered.Results: SGLT2 inhibitors correct a novel pathophysiological defect, have an insulin-independent action, are efficacious with glycosylated hemoglobin reduction ranging from 0.5% to 1.5%, promote weight loss, have a low incidence of hypoglycemia, complement the action of other antidiabetic agents, and can be used at any stage of diabetes. They are generally well tolerated. However, due to side effects, such as repeated urinary tract and genital infections, increased hematocrit, and decreased blood pressure, appropriate patient selection for drug initiation and close monitoring after initiation will be important. Results of ongoing clinical studies of the effect of SGLT2 inhibitors on diabetic complications and cardiovascular safety are crucial to determine the risk-benefit ratio. A recent decision by the Committee for Medicinal Products for Human Use of the European Medicines Agency has recommended approval of dapagliflozin for the treatment of type 2 diabetes as an adjunct to diet and exercise, in combination with other glucose-lowering medicinal products, including insulin, and as a monotherapy for metformin-intolerant patients. Clinical research also remains to be carried out on the long-term effects of glucosuria and other potential effects of SGLT2 inhibitors, especially in view of the observed increase in the incidence of bladder and breast cancer. SGLT2 inhibitors represent a promising approach for the treatment of diabetes, and could potentially be an addition to existing therapies.Keywords: sodium-glucose cotransporter type 2, SGLT2, inhibitors, kidney, glucosuria, oral diabetes agent, weight lossKim YBabu ARDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2012, Iss default, Pp 313-327 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Kim Y Babu AR Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
description	Yoojin Kim, Ambika R BabuDivision of Endocrinology, John Stroger Jr Hospital of Cook County and Rush University, Chicago, IL, USABackground: The kidney plays an important role in glucose metabolism, and has been considered a target for therapeutic intervention. The sodium-glucose cotransporter type 2 (SGLT2) mediates most of the glucose reabsorption from the proximal renal tubule. Inhibition of SGLT2 leads to glucosuria and provides a unique mechanism to lower elevated blood glucose levels in diabetes. The purpose of this review is to explore the physiology of SGLT2 and discuss several SGLT2 inhibitors which have clinical data in patients with type 2 diabetes.Methods: We performed a PubMed search using the terms &quot;SGLT2&quot; and &quot;SGLT2 inhibitor&quot; through April 10, 2012. Published articles, press releases, and abstracts presented at national and international meetings were considered.Results: SGLT2 inhibitors correct a novel pathophysiological defect, have an insulin-independent action, are efficacious with glycosylated hemoglobin reduction ranging from 0.5% to 1.5%, promote weight loss, have a low incidence of hypoglycemia, complement the action of other antidiabetic agents, and can be used at any stage of diabetes. They are generally well tolerated. However, due to side effects, such as repeated urinary tract and genital infections, increased hematocrit, and decreased blood pressure, appropriate patient selection for drug initiation and close monitoring after initiation will be important. Results of ongoing clinical studies of the effect of SGLT2 inhibitors on diabetic complications and cardiovascular safety are crucial to determine the risk-benefit ratio. A recent decision by the Committee for Medicinal Products for Human Use of the European Medicines Agency has recommended approval of dapagliflozin for the treatment of type 2 diabetes as an adjunct to diet and exercise, in combination with other glucose-lowering medicinal products, including insulin, and as a monotherapy for metformin-intolerant patients. Clinical research also remains to be carried out on the long-term effects of glucosuria and other potential effects of SGLT2 inhibitors, especially in view of the observed increase in the incidence of bladder and breast cancer. SGLT2 inhibitors represent a promising approach for the treatment of diabetes, and could potentially be an addition to existing therapies.Keywords: sodium-glucose cotransporter type 2, SGLT2, inhibitors, kidney, glucosuria, oral diabetes agent, weight loss
format	article
author	Kim Y Babu AR
author_facet	Kim Y Babu AR
author_sort	Kim Y
title	Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
title_short	Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
title_full	Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
title_fullStr	Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
title_full_unstemmed	Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
title_sort	clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/36e89783c9db45c0975ec77d8c5db5b5
work_keys_str_mv	AT kimy clinicalpotentialofsodiumglucosecotransporter2inhibitorsinthemanagementoftype2diabetes AT babuar clinicalpotentialofsodiumglucosecotransporter2inhibitorsinthemanagementoftype2diabetes
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Clinical potential of sodium-glucose cotransporter 2 inhibitors in the management of type 2 diabetes

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