New insights into cellular links between sodium-glucose cotransporter-2 inhibitors and ketogenesis

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are a newly developed class of highly effective antidiabetic therapies that normalize hyperglycemia via urinary glucose excretion. However, they may be accompanied by certain side effects that negatively impact their therapeutic benefits. SGLT2is induce a metabolic shift from glucose to fatty acids and thus increase lipolysis which, in turn, induces ketogenesis. The complete pathways linking SGLT2is to ketoacidosis have not yet been fully elucidated, though much is now known. Therefore, in this mechanistic study, we present the current knowledge and shed light upon the possible cellular pathways involved. A deeper understanding of the possible links between SGLT2is and ketogenesis could help to prevent adverse side effects in diabetic patients treated with these drugs.

Automated summary

SGLT2 inhibitors are a new class of antidiabetic drugs that normalize hyperglycemia through urinary glucose excretion. However, they may cause side effects such as ketoacidosis, which can negatively affect their therapeutic benefits. In this study, we present the current knowledge and shed light on the cellular pathways involved, aiming to prevent adverse side effects in diabetic patients treated with these drugs.