Journal
JOURNAL OF DIABETES INVESTIGATION
Volume 5, Issue 3, Pages 265-275Publisher
WILEY
DOI: 10.1111/jdi.12214
Keywords
Novel antidiabetic agents; Renal glucose reabsorption; Sodium glucose cotransporter 2 inhibitors
Categories
Funding
- Astellas Pharma Inc.
- Taisho Pharmaceutical Co., Ltd.
- Mitsubishi Tanabe Pharma Corporation
- Takeda Pharmaceutical Company Limited.
- GlaxoSmithKline plc
- Daiichi Sankyo Company, Limited.
- MSD
- Sanofi
- Novartis Pharma
- Dainippon Sumitomo Pharma Co., Ltd.
- Kyowa Hakko Kirin Co., Ltd.
- Eli Lilly Japan K.K.
- Shiratori Pharmaceutical Co., Ltd.
- Roche Diagnostics
- JT
- Nippon Boehringer Ingelheim Co., Ltd.
- Ono Pharmaceutical Co. Ltd.
- AstraZeneca PLC
- Kowa Company, Ltd.
- Japan Diabetes Foundation
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Type 2 diabetes is characterized by impaired insulin secretion from pancreatic -cells and/or reduced response of target tissues to insulin. Good glycemic control delays the development and slows the progression of micro- and macrovascular complications. Although there are numerous glucose-lowering agents in clinical use, only approximately half of type 2 diabetic patients achieve glycemic control, and undesirable side-effects often hamper treatment in those treated with the medications. There is a need for novel treatment options that can help overcome these difficulties. Sodium glucose cotransporter 2 (SGLT2) inhibitors have recently been developed as a novel potential therapeutic option for the treatment of type 2 diabetes. These drugs lower the plasma glucose concentration through inhibition of glucose reuptake in the kidney, independent of insulin secretion and insulin action, with a consequent lower risk of hypoglycemia. The data of clinical trials with monotherapy as well as combination therapy show that SGLT2 inhibitors have a blood glucose-lowering effect and also reduce bodyweight. A follow-up study shows long-term efficacy and the durability of these effects. SGLT2 inhibitors have the potential to reverse glucose toxicity, and to improve insulin resistance, blood pressure and lipid profile. The available data suggest a good tolerability profile. However, clinicians should carefully prescribe these drugs in light of already reported and/or unexpected side-effects. Further studies in larger numbers and longer-term clinical use data are required to place these agents in standard treatment of type 2 diabetes.
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