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The Effect of Sodium-Glucose Cotransporter Inhibitors on Renal Function as Adjunctive to Insulin in Adults with

Paschalis Karakasis1, Djordje S Popovic2, Dimitrios Patoulias3

  • 1Second Cardiology Department, Hippokration General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. pakar15@hotmail.com.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders
|January 5, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter (SGLT) inhibitors significantly reduce albuminuria in type 1 diabetes patients. While showing a neutral effect on overall renal function, further trials are needed to confirm their role in preventing diabetic nephropathy.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Type 1 diabetes (T1D) is associated with increased risk of kidney disease.
  • Albuminuria and declining renal function are key indicators of diabetic nephropathy.
  • Sodium-glucose cotransporter (SGLT) inhibitors are a class of drugs with potential renal benefits.

Purpose of the Study:

  • To systematically review randomized controlled trials (RCTs) on SGLT inhibitors in T1D.
  • To evaluate the impact of SGLT inhibitors on albuminuria and renal function.
  • To synthesize current evidence regarding SGLT inhibitors for diabetic nephropathy in T1D.

Main Methods:

  • Comprehensive literature search of Medline, Cochrane Library, and Scopus databases.
  • Double-independent study selection, data extraction, and quality assessment.
  • Three-level mixed-effects meta-analysis of data from 11 RCTs involving 5221 participants.

Main Results:

  • SGLT inhibitors significantly reduced urine albumin-to-creatinine ratio (UACR) by 23.13% (high evidence).
  • This albuminuria reduction was consistent across all SGLT inhibitors and dosages.
  • A neutral effect on estimated glomerular filtration rate (eGFR) was observed (moderate evidence), with empagliflozin showing a significant eGFR reduction.

Conclusions:

  • Adjunctive SGLT inhibitor therapy effectively reduces albuminuria in T1D.
  • SGLT inhibitors demonstrate a neutral effect on creatinine clearance, a measure of renal function.
  • Further renal outcome trials are necessary to establish the role of SGLT inhibitors in managing diabetic nephropathy in T1D.
Keywords:
AlbuminuriaGlomerular filtration rateRenal functionSGLT inhibitorsType 1 diabetes mellitus

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