SGLT2 inhibitors and autophagy in diabetes

Autophagy is a physiological event in mammalian cells to promote cell survival and efficiency in tissues, but it may turn to be a pathological process in disease conditions such as in diabetes. Chronic hyperglycemia induces aberrant autophagy and promotes cellular death as a main underlying cause of diabetes-related complications. Therefore, autophagy-modifying therapy may be of value to prevent the development of complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a class of newly introduced antidiabetic drugs that achieve normoglycemia through causing overt glycosuria. There is evidence that these drugs may have pleiotropic extra-glycemic benefits, but their effect on the autophagy process is unclear; therefore, this review was undertaken to clarify the possible effects of SGLT2is on autophagy.

Automated summary

Autophagy is a dual process that can promote cell survival and efficiency in normal conditions but become pathological in disease states such as diabetes. Chronic hyperglycemia induces aberrant autophagy and leads to cellular death, which is a major underlying cause of diabetes-related complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are newly introduced antidiabetic drugs that may have additional benefits beyond glycemic control, but their effect on autophagy remains unclear. This review aims to elucidate the potential effects of SGLT2is on autophagy.