Practical Approach to Initiating SGLT2 Inhibitors in Type 2 Diabetes/Includes correction: PMC5630547

• Type of Material: Article
• Authors: Fernando Gomez-Peralta, Segovia General Hospital; Cristina Abreu, Segovia Gen Hosp; Albert Lecube, University of Lleida; Diego Bellido, University of Lleida; Alfonso Soto, Hospital de La Coruña; Cristóbal Morales, Virgen Macarena Hospital; Miguel Brito-Sanfiel, Hospital Universitario Puerta de Hierro Majadahonda; Guillermo Umpierrez, Emory University
• Language: English
• Date: 2017-10-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Final Published Version
• Copyright Statement: © 2017, The Author(s).
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s13300-017-0277-0
• Title of Journal or Parent Work: Diabetes Therapy
• ISSN: 1869-6953
• Volume: 8
• Issue: 5
• Start Page: 953
• End Page: 962
• Keywords: DAPAGLIFLOZIN; CLINICAL ENDOCRINOLOGISTS; DOUBLE-BLIND; Life Sciences & Biomedicine; PLACEBO-CONTROLLED TRIAL; RANDOMIZED-TRIAL; SGLT2 inhibitors; AMERICAN ASSOCIATION; Type 2 diabetes; ADD-ON; Management; Initiation; INADEQUATE GLYCEMIC CONTROL; GLUCOSE COTRANSPORTER 2; METFORMIN PLUS SULFONYLUREA; Concomitant; Science & Technology; Endocrinology & Metabolism
• Research Categories: Health Sciences, Nutrition; Health Sciences, Medicine and Surgery

Abstract

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetes-related hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes. Beneficial effects on kidney disease progression, cardiovascular and all-cause mortality, and hospitalization for heart failure have also been demonstrated with one SGLT2 inhibitor (empagliflozin). Potential adverse events resulting from their mechanism of action or related to concomitant therapies are reviewed. A treatment algorithm for the adjustment of concomitant therapies after initiating SGLT2 inhibitors is also proposed.