The Emergence of Sodium glucose Co-transporter 2 Inhibitors as a Successful Agent for Management of Diabetes Mellitus

Authors: Mandal K

DOI: 10.23880/doij-16000145

Volume 2, Issue 1

Abstract

Most of current guidelines for management of diabetes mellitus are recommending comprehensive strategy inclusive of adequate control of blood pressure and weight apart from hyperglycemia . Several innovative anti-diabetic molecules have been launched in recent years. Out of these agents, injectable incretin based therapy like GLP 1 receptor agonist has shown great promise, but high cost and injectable route of administration have prevented their wide acceptance. In the last 4 years, sodium glucose co-transporter inhibitor, which works in kidney to induce excess glucose elimination through urine, has been launched globally. This oral anti-diabetic agent works comprehensively and more intensively than existing dipeptyl peptidase 4 inhibitors (DPP4i). Apart from its’ excellent glycemic benefit with negligible risk of hypoglycemia, and extra-glycemic benefits like weight loss and blood pressure control, compatibility with almost all existing anti-diabetic agents, possible positive impact on cardiovascular and renal outcomes, and rapid reversal of glucotoxicity in type 2 diabetes mellitus patient whose renal function is intact, make them irresistible options for management of type 2 diabetes mellitus. However, despite huge advantages, injudicious ,use of agents this class throws up unique challenges like genito- urinary infections, eu-glycemic keto-acidosis, electrolyte imbalance etc.. This review tries to give a comprehensive and balanced view of this class of drug.

Keywords: Diabetes Mellitus Gliflozin; SGLT2 inhibitors; Kidney; DKA

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