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The nephrological perspective on SGLT-2 inhibitors in type 1 diabetes

Pieter Gillard1, Oliver Schnell2, Per-Henrik Groop3

  • 1Department of Endocrinology, University Hospitals Leuven, KU Leuven, Belgium.

Diabetes Research and Clinical Practice
|September 24, 2020
PubMed

Insights

Sodium-glucose co-transporter inhibitors (SGLT-Is) show promise for managing type 1 diabetes mellitus (T1DM) and its associated kidney disease. Emerging data suggests potential renoprotective effects, offering new therapeutic avenues.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Type 1 diabetes mellitus (T1DM) prevalence is rising globally, increasing the risk of cardiovascular and renal comorbidities, including end-stage renal disease (ESRD).
  • Existing treatments for chronic and/or diabetic kidney disease (CKD/DKD) in T1DM patients require improvement.
  • Sodium-glucose co-transporter inhibitors (SGLT-Is), including dual SGLT-1/-2 inhibitors, were approved in 2019 by the EMA for glycemic control in T1DM with obesity, but lack FDA approval for T1DM or kidney disease treatment.

Purpose of the Study:

  • To review and discuss the latest data on SGLT inhibition in T1DM.
  • To provide an update on the nephrological perspective of SGLT inhibitors in T1DM.
  • To explore the potential renoprotective effects of SGLT inhibitors in T1DM.

Main Methods:

  • Literature review of recent clinical trials and studies on SGLT inhibitors in T1DM.
  • Analysis of data from cardiovascular and renal outcome trials involving SGLT inhibitors in type 2 diabetes mellitus.
  • Synthesis of nephrological insights regarding SGLT inhibition in T1DM.

Main Results:

  • SGLT inhibitors have demonstrated renoprotective effects in type 2 diabetes mellitus.
  • Initial efficacy trials indicate potential benefits of SGLT inhibitors on renal function and kidney disease in T1DM.
  • SGLT-1/-2 inhibitors and SGLT-2 inhibitors are approved by EMA for glycemic control in T1DM with obesity, but not by FDA for T1DM or kidney disease.

Conclusions:

  • SGLT inhibitors represent a promising therapeutic strategy for managing T1DM and its associated kidney complications.
  • Further research and clinical trials are warranted to fully elucidate the role of SGLT inhibitors in T1DM nephropathy.
  • The nephrological perspective highlights the potential of SGLT inhibition to improve renal outcomes in T1DM patients.
Keywords:
DiabetesDiabetic kidney diseaseKidney diseaseRenal effectsSGLT inhibitionSGLT-2 inhibitorType 1 diabetes mellitus

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