What does SGLT2 inhibitor mean?

Sodium-glucose transport protein 2 (SGLT2) inhibitors are a class of medications used to treat type 2 diabetes. They’re also known as gliflozins. SGLT2 inhibitors prevent the reabsorption of glucose from blood that’s filtered through your kidneys, therefore facilitating glucose excretion in the urine.

How do SGLT2 inhibitors work?

SGLT2 inhibitors work by preventing the kidneys from reabsorbing glucose back into the blood. This allows the kidneys to lower blood glucose levels and the excess glucose in the blood is removed from the body via urine.

When do you use SGLT2 inhibitors?

SGLT2 inhibitors are currently indicated in Europe and the USA, as first- or second-line treatments of type 2 diabetes mellitus (T2DM) in patients with established cardiovascular disease, high/very high cardiovascular risk, renal disease or heart failure.

What happens when SGLT2 is inhibited?

SGLT2 inhibitors function through a novel mechanism of reducing renal tubular glucose reabsorption, producing a reduction in blood glucose without stimulating insulin release.

What are the benefits of SGLT2 inhibitors?

Sodium–glucose cotransporter 2 (SGLT2) inhibitors increase natriuresis and glycosuria, resulting in various beneficial effects on the cardiovascular and renal systems. Together, these effects preserve renal function and reduce the risk of heart failure decompensation and hospitalization.

What happens if SGLT1 is inhibited?

Inhibition of SGLT1 delays and reduces glucose absorption in the small intestine, thus improving post meal glycemic control. This is beneficial particularly in patients with declining renal function where SGLT2 inhibition is less effective.

How do SGLT2 inhibitors help in heart failure?

SGLT2 inhibitors are especially useful in patients with heart failure and comorbid type 2 diabetes (T2D) because they block the reabsorption of filtered glucose, thereby reducing the risk of heart failure events.

How do SGLT2 inhibitors work in CKD?

SGLT2 inhibitors are effective at slowing the progression of kidney disease, reducing heart failure, and lowering the risk of kidney failure and death in people with kidney disease and type 2 diabetes. SGLT2 inhibitors also protect the kidneys of people with CKD who do not have diabetes.

Why do SGLT2 inhibitors not cause hypoglycemia?

SGLT2 inhibitors only lower plasma glucose levels by blocking reabsorption of filtered glucose, which falls as plasma levels fall. Thus, they do not usually cause hypoglycemia in the absence of therapies that otherwise cause hypoglycemia.

How do SGLT2 inhibitors bind?

The free drugs are filtered from plasma at the glomerulus where they then bind to the luminal membrane of the proximal tubule. The SGLT2 inhibitors bind to SGLT2 in the luminal membrane of the early (S1 and S2) segments of the nephron, where they may block up to 60% of glucose reabsorption.

Why are SGLT2 inhibitors used in heart failure?

Sodium-glucose cotransporter-2 (SGLT2) inhibitors can decrease risk for heart failure in patients with type 2 diabetes and can decrease risk of major cardiovascular events in patients with heart failure (HF) and diabetes. Specific SGLT2 inhibitors can also decrease major cardiovascular events in patients with HF only.

How do SGLT2 inhibitors protect the heart?

Another proposed mechanism for the beneficial effects of SGLT2 inhibitors is inhibition of the sodium-hydrogen exchanger (NHE1) activity which is up-regulated both in T2DM and heart failure [38]. By inhibiting the NHE1 receptors, SGLT2 inhibitors may protect the heart from toxic intracellular Ca2+ overload [39, 40].

How do SGLT1 inhibitors work?

SGLT1 inhibitors work on a different transport protein, sodium-glucose like co-transporter 1. Sodium-glucose-like co-transporter 1 also has important roles in the reabsorption of glucose. It has a more minor role in the kidneys, working further down in the tubules to reabsorb glucose.

What drugs are SGLT1 inhibitors?

Intestinal SGLT-1. By inhibiting SGLT-1, sotagliflozin delays glucose absorption in the distal small intestine and colon, consequently reducing Post Prandial Glucose (PPG) and improving glycemic control in type 2 diabetes subjects [15, 41].

How do SGLT2 inhibitors reduce blood pressure?

SGLT2 inhibitors significantly decreased SBP after 1 month and DBP after 6 months in obese patients with type 2 diabetes. The main mechanism of the BP-lowering effect may be plasma volume reduction by osmotic diuresis at 2 weeks and by natriuresis at 6 months after SGLT2 inhibitor administration.

Why are SGLT2 inhibitors contraindicated in renal failure?

Because SGLT2 inhibitors can cause contraction of blood volume, physicians are advised to consider factors that might increase the risk of acute kidney injury, including hypovolemia, chronic renal insufficiency, chronic heart failure, and concomitant medications (e.g. diuretics, angiotensin-converting enzyme inhibitors …

Can SGLT2 cause renal failure?

Abstract. Background and aims: Sodium-glucose-cotransporter-2 (SGLT2) inhibitors have recently been approved for the treatment of type II diabetes mellitus (T2DM). It has been proposed that these agents could induce acute renal failure (ARF) under certain conditions.

Why are SGLT2 inhibitors not used in type 1 diabetes?

Cherney also reported a small but statistically significant increase in hematocrit in type 1 diabetic patients treated with the SGLT2 inhibitor empagliflozin [35]. As mentioned above, SGLT2 inhibitors can cause an increase in ketogenesis, which can have detrimental effects in the form of DKA.

How do SGLT2 inhibitors cause weight loss?

Effects on Body Weight and Adiposity. SGLT2 inhibitors directly cause body weight loss via glucose excretion (calorie loss) in the kidneys. Inhibition of SGLT2 acts in a glucose-dependent manner and can result in the elimination of about 60–100 g of glucose per day in the urine.

How are SGLT2 inhibitors absorbed?

Oral SGLT2 inhibitors are rapidly absorbed into the blood stream where they remain in in the circulation for hours. On glomerular filtration, they bind specifically to SGLT2 in the luminal membrane of the early proximal tubule to reduce glucose reabsorption by 50-60%.

What drugs are SGLT2 inhibitors?

SGLT2 inhibitors are a class of prescription medicines that are FDA-approved for use with diet and exercise to lower blood sugar in adults with type 2 diabetes. Medicines in the SGLT2 inhibitor class include canagliflozin, dapagliflozin, and empagliflozin.

Why do SGLT2 inhibitors improve heart failure?

SGLT-2 inhibitors could increase mitochondrial calcium levels and reduce cytoplasmic sodium and calcium levels by inhibiting NHE (43). SGLT-2 inhibitors can also downregulate the activity of Na+/H+ exchanger 3 in the proximal tubule, through which, promote natriuresis and reduce heart failure (44).

What are SGLT1 inhibitors?

SGLT1 Inhibitors are new diabetes medications that delay and reduce the absorption of glucose in the small intestine. SGLT1 treatment could improve your diabetes control, significantly reducing blood sugars after eating.

How much does SGLT2 lower blood pressure?

Canagliflozin recipients showed an early and sustained reduction in BP (–3.5 mm Hg versus baseline); this was consistent across all patient subgroups, but of a smaller magnitude than reductions in office BP reported in other SGLT2i studies (Tables 1 and 2).

Does dapagliflozin reduce blood pressure?

In conclusion, dapagliflozin 10 mg induces a modest reduction in blood pressure compared with placebo in patients with diabetes with a low risk of orthostatic reactions, regardless of baseline blood pressure.