SGLT-2 inhibitors and the metabolic fulcrum
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 8
Abstract
Treatment potential of sodium glucose transporter-2 (SGLT-2) inhibitors in diabetes was first reported more than two decades ago, but their recently testified effect on reduction of major cardiovascular endpoints in outcome trials has led to renewed enthusiasm in them. Their role in the management of type 2 diabetes assumes more significance given that it is known that kidneys are not just innocent bystanders in this chronic disease, but are also involved in its pathogenesis. Pragmatic useof SGLT-2 inhibitors entails classifying patients based on their metabolic state- the so called metabolic fulcrum. When used in carefully selected patients, these drugs not only help in glycemia control, but also have a variety of favourable effects, like reduction of blood pressure and cardiovascular mortality, and improvement in clinical renal endpoints. In this mini review, we briefly describe the rationale of use of SGLT-2 inhibitors, their effects, usage and major side effects.
Authors and Affiliations
Ashish Sehgal
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