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Unexpected Pleiotropic Effects of SGLT2 Inhibitors: Pearls and Pitfalls of This Novel Antidiabetic Class.

Abstract
Sodium-glucose co-transporter 2 (SGLT2) inhibitors facilitate urine glucose excretion by reducing glucose reabsorption, leading to ameliorate glycemic control. While the main characteristics of type 2 diabetes mellitus are insufficient insulin secretion and insulin resistance, SGLT2 inhibitors have some favorable effects on pancreatic β-cell function and insulin sensitivity. SGLT2 inhibitors ameliorate fatty liver and reduce visceral fat mass. Furthermore, it has been noted that SGLT2 inhibitors have cardio-protective and renal protective effects in addition to their glucose-lowering effect. In addition, several kinds of SGLT2 inhibitors are used in patients with type 1 diabetes mellitus as an adjuvant therapy to insulin. Taken together, SGLT2 inhibitors have amazing multifaceted effects that are far beyond prediction like some emerging magical medicine. Thereby, SGLT2 inhibitors are very promising as relatively new anti-diabetic drugs and are being paid attention in various aspects. It is noted, however, that SGLT2 inhibitors have several side effects such as urinary tract infection or genital infection. In addition, we should bear in mind the possibility of diabetic ketoacidosis, especially when we use SGLT2 inhibitors in patients with poor insulin secretory capacity.
AuthorsHideaki Kaneto, Atsushi Obata, Tomohiko Kimura, Masashi Shimoda, Tomoe Kinoshita, Taka-Aki Matsuoka, Kohei Kaku
JournalInternational journal of molecular sciences (Int J Mol Sci) Vol. 22 Issue 6 (Mar 17 2021) ISSN: 1422-0067 [Electronic] Switzerland
PMID33802741 (Publication Type: Journal Article, Review)
Chemical References
  • Cardiotonic Agents
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
Topics
  • Animals
  • Cardiotonic Agents (pharmacology, therapeutic use)
  • Diabetes Mellitus, Type 2 (drug therapy, pathology)
  • Humans
  • Hypoglycemic Agents (pharmacology)
  • Insulin Resistance
  • Insulin-Secreting Cells (drug effects, metabolism, pathology)
  • Sodium-Glucose Transporter 2 Inhibitors (pharmacology)

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