SGLT2 Inhibitors

 

Who?
Sodium glucose co-transporter 2 (SGLT2) inhibitors are a relatively new class of drugs recommended for persons with type 2 diabetes who have poorly controlled blood glucose and high HbA1c levels.
What?
Taken as an oral tablet.
There are three types of SGLT2 inhibitors that are currently available:

 
Where?
These pills work by preventing glucose from being absorbed in the kidneys. As a result, they decrease glucose in the blood and cause it to spill into the urine.
When?
The treatment plan will differ for each person, but in general SGLT2 inhibitors are taken once a day before the first meal. The typical dose is 100 – 300 mg (canagliflozin), 5-10 mg (dapagliflozin), or 10 – 25 mg (empagliflozin), depending on the patient’s needs. In most cases, SGLT2 inhibitors are used in addition to other diabetes medications.
Advantages?
  • These medications typically lower HbA1c levels by 0.5 – 1% after about 6 months of therapy.
  • Some patients report mild weight loss after taking SGLT2 inhibitors.

Other considerations
  • SGLT2 inhibitors may increase urination and raise the risk of female yeast infections and urinary tract infections. These drugs can also lead to low blood pressure.
  • Kidney function needs to be tested before and during treatment with SGLT2 inhibitors
  • Persons with severe kidney disease or on dialysis are not recommended to be on this medicine
  • New evidence suggests that SGLT2 inhibitors might be related to the development of diabetic ketoacidosis in some patients
  • Though use of SGLT2 inhibitors in type 1 diabetes has been described, the safety of these drugs has not been studied and are not currently FDA recommended for the management of type 1 diabetes

 

 

 

 

 

 

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