Sodium-glucose co-transporter 2(SGLT2) inhibitors renal benefits and beyond
Diabetes is a disaease of Insulin insufficiency or resistance which implications on almost every organ and tissue of human body. It plays a direct or indirect role in causation or progression of many chronic conditions like Coronary Heart disease, Cerebrovascular accidents, Chronic Kidney disaease, limb amputation and so forth. It increases the risk and frequency of infections and delays the recovery as well. Management strategies include dietary management,exercise, Oral Antidiabetic drugs,Insulin formulations, pancreatic transplantation. The goal of these management strategies, usually employed in combination, is good glycemic control so as to avoid development of diabetic complications in the long run.
Sodium-glucose co-transporter 2(SGLT2) inhibitors
There are various classes of Oral Antidiabetic drugs(OAD) which form the basis of management of Diabetes Mellitus type 2 in particular as Type 1 Diabetes Mellitus invariably needs insulin for glycemic control. Sodium-glucose co-transporter 2(SGLT2) inhibitors are a class of OAD, approved by FDA for management of adults with type 2 diabetes. There are many SGLT2 inhibitors currently which can be used in patients with diabetes notably dapagliflozin, canagliflozin, empagliflozin. These oral antidiabetic drugs act by locking the SGLT2 transporters in proximal tubule of nephron and hence lead to glycosuria. They improve glycemic control, reduce body weight, and improve blood pressure control. Furthermore, evidence suggests that SGLT2 inhibitors have renoprotective, Cardiovascular and hypouricemic benefits among others. These benefits of SGLT2i slow progression of diabetic kidney disease. There is some evidence of increased risk of genitourinary fungal infections, Ketoacidosis and Fournier,s gangrene with use of SGLT2i.
Considering the added benefits of SGLT2i like renoprotection, weight loss, bP control, decreased CV morbidity and mortality with its use has provided an option of retarding the progression of Diabetic Nephropathy and improved survival of Diabetic patients. As more and more information with the experience of using this drug is published many unanswered questions about mechanism of these benefits and adverse events will be answered.
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