SGLT2 Inhibitors (Gliflozins)

SGLT2 inhibitors help the kidneys lower blood glucose levels
SGLT2 inhibitors help the kidneys lower blood glucose levels

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new group of oral medications used for treating type 2 diabetes. The drugs work by helping the kidneys to lower blood glucose levels.

SGLT2 inhibitors have been approved for use as a treatment for diabetes since 2013. They are taken once a day with or without food.

Drugs in this class

The following drugs belong to the SGLT2 inhibitors class (trade name first, generic name in brackets):

As of April 2013, dapagliflozin has been approved by NHS Scotland for prescribing in certain people with type 2 diabetes, while canagliflozin has been approved by the FDA for use in the United States.

How do SGLT2 inhibitors work?

SGLT2 inhibitors work by preventing the kidneys from reabsorbing glucose back into the blood.

This allows the kidneys to lower blood glucose levels and the excess glucose in the blood is removed from the body via urine.

The more technical answer is that the drugs inhibit a form of proteins, which help to reabsorb glucose into the blood, called sodium-glucose transport proteins (SGLT2). By blocking these proteins, less glucose is reabsorbed into the blood and the excess glucose is passed out as urine.

Who are SGLT2 inhibitors suitable for?

SGLT2 inhibitors may be suitable for people with type 2 diabetes that have high blood glucose levels despite being on a medication regimen such as metformin and insulin.

SGLT2 inhibitors are not recommended for prescribing to people with kidney disease (nephropathy) as kidney disease prevents the drug from working sufficiently well.

What are the benefits of SGLT2 inhibitors?

SGLT2 inhibitors help to remove glucose from the blood and therefore help to lower blood glucose levels.

By removing glucose from the body, SGLT2 inhibitors can also have benefits for weight loss.

Side effects

As the drugs cause more glucose to be excreted in the urine, there is a higher chance of getting genital and urinary tract infections. These side effects are more common in women than in men.

Patients taking SGLT2 inhibitors with insulin should be aware of the risks of hypoglycemia.

Long term side effects of the drugs in humans are as yet not known. Clinical trials into dapagliflozin showed an in incidence of liver damage and breast and bladder cancers amongst those taking the drug but not to a high enough degree to indicate a clear increase in risk.

Clinical trials into canagliflozin showed increases in both LDL and HDL cholesterol.