Use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus

Abstract

Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.

Sodium–Glucose Cotransporter 2 Inhibition and Diabetic Kidney Disease

“…Therefore, agents that control hyperglycemia safely while also preventing or treating DKD are urgently needed. Over the past three decades, discovery and elucidation of the role of sodium symporters in glucose reabsorption, and thereby glucose homeostasis, have pointed to sodium-glucose cotransporter 2 (SGLT2) inhibition as a viable therapeutic target (16)(17)(18)(19). In cardiovascular disease (CVD) outcomes trials conducted for safety, SGLT2 inhibitors actually have demonstrated clear benefits on CVD and CKD.…”

Development and optimization of sitagliptin and dapagliflozin loaded oral self-nanoemulsifying formulation against type 2 diabetes mellitus

“…While SGLT1 is the main glucose transporter in the small intestine, SGLT2 is predominantly expressed on epithelial cells surface on the lining of the S1 segment of the proximal convoluted tubule (Fioretto & Avogaro, 2017). Studies have shown DN to be the most selective for SGLT2 (1200-fold over SGLT1), which could be the better drug for the treatment of type 2 diabetes (Santos et al, 2017;Wilding et al, 2017).…”

“…SGLT2 inhibitors such as DN and dipeptidyl peptidase-4 (DPP-4) inhibitors like SN is potentially beneficial in achieving glycemic control without the risk of hypoglycemia or weight gain treatment of type 2 diabetes (Santos et al, 2017). A recent study suggests that in patients with type 2 diabetes, combination therapy (Ji et al, 2016) provided additional clinical benefit and is well tolerated.…”

miR‑204‑5p promotes diabetic retinopathy development via downregulation of microtubule‑associated protein 1 light chain 3

“…Diabetes mellitus is one of the most common types of chronic disease with extensive morbidity and mortality worldwide (1). Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and is a frequent cause of preventable blindness worldwide (2).…”