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Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives

Mathew John1, Deepa Gopinath1, Rejitha Jagesh1

  • 1Department of Endocrinology and Diabetes, Providence Endocrine and Diabetes Specialty Centre, Thiruvananthapuram, Kerala, India.

Indian Journal of Endocrinology and Metabolism
|February 24, 2016
PubMed

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve glycemic control in type 2 diabetes patients on insulin. These agents offer benefits like weight loss and reduced hypoglycemia risk, with careful use advised for ketoacidosis-prone individuals.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Nephrology

Background:

  • Type 2 diabetes management is challenging, often requiring insulin intensification.
  • Insulin therapy can lead to weight gain and hypoglycemia.
  • Beta-cell failure progression necessitates complex treatment regimens.

Purpose of the Study:

  • To evaluate the efficacy and safety of Sodium-glucose cotransporter 2 (SGLT2) inhibitors as an add-on therapy to insulin in type 2 diabetes.
  • To assess the impact of SGLT2 inhibitors on glycemic control, weight, and hypoglycemia risk.
  • To identify specific patient subsets requiring cautious SGLT2 inhibitor use.

Main Methods:

  • Review of clinical trial data on SGLT2 inhibitors in type 2 diabetes patients.
  • Analysis of effects on glycemic control (HbA1c), body weight, and hypoglycemia events.
  • Assessment of adverse events, including infections and ketoacidosis risk.

Main Results:

  • Adding SGLT2 inhibitors to insulin improved glycemic control without significant weight gain or increased hypoglycemia.
  • SGLT2 inhibitors demonstrated potential benefits in weight loss and blood pressure reduction.
  • Common risks included genital mycotic and urinary tract infections; caution is advised for ketoacidosis-prone patients.

Conclusions:

  • SGLT2 inhibitors are a valuable addition to insulin therapy for type 2 diabetes, offering glycemic benefits with a favorable side-effect profile.
  • Empagliflozin, an SGLT2 inhibitor, has shown cardiovascular outcome benefits.
  • Careful patient selection is crucial, particularly for those at risk of diabetic ketoacidosis.
Keywords:
Canagliflozindapagliflozinempagliflozinsodium glucose cotransporter 2type 2 diabetes

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