Related Experiment Video

Updated: Dec 29, 2025

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test
06:59

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test

Published on: November 13, 2016

11.3K

Renal physiology of glucose handling and therapeutic implications

David Z Cherney1,2,3,4, Mehmet Kanbay5, Julie A Lovshin1,4,6,7

  • 1Toronto General Hospital Research Institute, UHN, Toronto, ON, Canada.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|February 1, 2020
PubMed

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors offer significant cardiovascular and renal benefits for type 2 diabetes patients, independent of glucose control. These effects extend across various chronic kidney disease stages, expanding their therapeutic potential.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors were initially approved for glycemic control in type 2 diabetes (T2D).
  • Their use was limited in chronic kidney disease (CKD) due to attenuated glycemic effects at later stages.
  • Emerging evidence highlights benefits beyond glucose lowering, including cardiovascular and renal protection.

Purpose of the Study:

  • To review the evolving rationale for SGLT2 inhibitor use in T2D and CKD.
  • To discuss the pharmacodynamic and clinical effects of SGLT2 inhibitors beyond glycemic control.
  • To summarize evidence for cardiovascular and renal benefits, including independence from glycemic control.

Main Methods:

  • Review of clinical trial data, including cardiovascular outcome trials (EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58) and renal protection trials (CREDENCE).
  • Analysis of pharmacodynamic effects, including antihypertensive, antialbuminuric, and glomerular hypertension reduction.
  • Assessment of SGLT2 inhibitor efficacy across different stages of CKD and in albuminuric T2D patients.

Main Results:

  • SGLT2 inhibitors demonstrate significant reductions in cardiovascular and renal events, independent of glycemic control.
  • Antihypertensive and antialbuminuric effects are preserved across CKD stages.
  • The CREDENCE trial confirmed renal and cardiovascular benefits in albuminuric T2D patients.

Conclusions:

  • SGLT2 inhibitors have evolved into crucial therapies for managing T2D, offering substantial cardiovascular and renal protection.
  • Their benefits extend beyond glycemic control and are evident even in later stages of CKD.
  • Ongoing research will further define the role of SGLT2 inhibitors in non-diabetic CKD and type 1 diabetes.
Keywords:
cardiovascular diseasediabetesdiabetic kidney diseaseheart failure

More Related Videos

Extracellular Glucose Depletion as an Indirect Measure of Glucose Uptake in Cells and Tissues Ex Vivo10:35

Extracellular Glucose Depletion as an Indirect Measure of Glucose Uptake in Cells and Tissues Ex Vivo

Published on: April 6, 2022

3.1K
Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique07:35

Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique

Published on: January 26, 2024

2.0K

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
735
Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
3.6K
Hormones Regulating Blood Glucose01:16

Hormones Regulating Blood Glucose

Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...
6.1K
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
791
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are...
2.0K
Overview of Carbohydrate Metabolism01:19

Overview of Carbohydrate Metabolism

Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
3.1K