Sodium-glucose co-transporter-2 inhibitors as anti-diabetic agents: a review.
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Date
2015-09
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Abstract
The incidence and prevalence of Type 2 diabetes mellitus (T2DM) have been
increasing worldwide. However, existing therapeutic classes of anti-diabetic
drugs are not adequately effective in achieving and maintaining long-term
glycemic control in the most patients. The majority of the drugs control blood
sugar without addressing the basic pathology of insulin resistance and relative
defi ciency. Moreover, side effects such as hypoglycemia and weight gain, of both
new and established drugs need to be considered prior to treating a patient. An
emerging anti-hyperglycemic intervention, the sodium glucose co-transporter 2
(SGLT2) inhibitor acts by a novel mechanism. Under physiological conditions,
SGLT2 accounts for 90% of the glucose re-absorption in the kidney, while the
SGLT2 inhibitors result in an increase in urinary excretion of glucose and lower
plasma glucose levels. Here, the pros and cons of SGLT2 inhibitors are considered,
while approaching a patient with T2DM. The basic biochemistry and physiology
underlying the mechanisms of SGLT2 inhibitors are discussed alongside its clinical
pharmacology, with a focus on metabolic changes associated with urinary glucose
loss. Finally, a consideration of Food and Drug Administration safety concerns
associated with acidosis due to SGLT2 inhibitor usage is presented, to allow a
complete understanding of the utility of these molecules in the light of existing
T2DM therapies.
Description
Keywords
Anti-hyperglycemic drugs, Cardiovascular safety, Food and Drug Administration, Hyperglycemia, Renal function, Sodium-glucose co-transporter-2 inhibitors, Type 2 diabetes mellitus
Citation
Mistry Chirag B, Vaishnav Radhika A, Shah Mona H. Sodium-glucose co-transporter-2 inhibitors as anti-diabetic agents: a review. International Journal of Basic & Clinical Pharmacology. 2015 Sep-Oct; 4(5): 815-821.