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Sodium-glucose transport: role in diabetes mellitus and potential clinical implications

Volker Vallon1, Kumar Sharma

  • 1Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego/Veterans Affairs San Diego Healthcare System, San Diego, USA.

Current Opinion in Nephrology and Hypertension
|June 12, 2010
PubMed
Abstract

Insights

Selective SGLT2 inhibitors offer a novel approach to glycemic control for type 2 diabetes, enhancing glucose excretion without significant hypoglycemia. Further research is needed to explore long-term effects and potential benefits for diabetic nephropathy.

Area of Science:

  • Endocrinology
  • Nephrology
  • Pharmacology

Background:

  • Current glycemic control methods for diabetes have limitations in efficacy and complication reduction.
  • Selective inhibition of sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubules offers a novel therapeutic strategy.

Purpose of the Study:

  • To review the efficacy and safety of SGLT2 inhibitors for glycemic control in type 2 diabetes.
  • To evaluate the impact of SGLT2 inhibition on body weight, blood pressure, and infection risk.

Main Methods:

  • Review of current literature on SGLT2 inhibitors.
  • Analysis of clinical trial data regarding glycemic control, adverse events, and metabolic parameters.

Main Results:

  • SGLT2 inhibitors effectively improve glycemic control in type 2 diabetes without causing significant hypoglycemia or altering volume status/GFR.
  • Associated benefits include weight reduction and decreased systolic blood pressure.
  • Increased glucosuria elevates the risk of genital infections but not urinary tract infections.

Conclusions:

  • SGLT2 inhibitors represent a significant advancement in diabetes treatment, reducing plasma glucose without increased insulin secretion, hypoglycemia, or weight gain.
  • Their glucose-excreting mechanism is beneficial for caloric excess conditions.
  • Long-term effects, extrarenal safety, and potential direct renal protective effects independent of hyperglycemia require further investigation.

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