Dapagliflozin: more than just another oral glucose-lowering agent?

Importance of the field: With current hypoglycemic therapies, only half of type 2 diabetes mellitus (T2DM) patients achieve optimal glycemic control and even fewer maintain it. Therefore, there is an unmet need for novel antidiabetic agents. Dapagliflozin, a selective inhibitor of sodium glucose transporter 2 (SGLT2), targets hyperglycemia independently of insulin, via decreasing renal glucose reabsorption. Areas covered in this review: We critically assess the results of up-to-date clinical trials with dapagliflozin in patients with T2DM and discuss its potential therapeutic applications. What the reader will gain: Dapagliflozin, apart from targeting hyperglycemia, also exerts beneficial effects on blood pressure, lipid profile, body weight and waist circumference. Furthermore, serum uric acid and high sensitivity C-reactive protein levels were decreased in dapagliflozin-treated patients. However, there are also potentially negative effects related to dapagliflozin use that need to be addressed, such as increased hematocrit and serum parathyroid levels and the possibility of a higher rate of urinary tract and genital infections. Take home message: The use of dapagliflozin in the treatment of T2DM patients seems promising but more evidence is needed.