SGLT2 Inhibitors: Pharmacology and Expanding Role Beyond Diabetes

Shivcharan Kamble, Rashee Shahu, Sunita Kode, Tejaswini Gaikwad, Pooja Rasal,

doi:10.5281/zenodo.18322823

Review Paper | Open Access
Volume 03 | Issue 01 | Article Id IJSRT/260401076

SGLT2 Inhibitors: Pharmacology and Expanding Role Beyond Diabetes
Shivcharan Kamble* Rashee Shahu Sunita Kode Tejaswini Gaikwad Pooja Rasal
Department of Pharmacology, JES’s SND College of Pharmacy, Babhulgaon (Yeola), India

Abstract

SGLT2s are a new type of oral diabetes treatment that work by preventing glucose from being absorbed through the kidneys, which helps the body get rid of extra glucose through the urine. Unlike traditional ways to treat diabetes, SGLT2 inhibitors work without using insulin, so people taking this type of medicine can manage their blood sugar levels with less chance of developing low blood sugar (hypoglycemia). SGLT2 inhibitors also may help people lose a small amount of weight and maintain lower blood pressure. The benefits of taking SGLT2 inhibitors go beyond just controlling blood sugar levels. Clinical studies are showing that SGLT2 inhibitors help protect the heart and kidneys. In fact, large studies of patients with heart failure have found that SGLT2 inhibitors reduce the risk of being hospitalized for heart failure; slow down the progression of chronic kidney disease; and lower the risk of dying from cardiovascular causes, even in people who do not have diabetes. The additional benefits of taking SGLT2 inhibitors may be due to blood flow changes throughout the body, including the way the heart works, how the body metabolizes food, and how inflammation occurs in the body. Although SGLT2 inhibitors can cause unwanted effects (such as infections in the genital area or very rarely euglycemic diabetic ketoacidosis), the overall benefits of taking SGLT2 inhibitors greatly outweigh the risks if the right patients are chosen and monitored closely. This expanding role for SGLT2 inhibitors in combination with other medications (for example, when treating patients with diabetes, high blood pressure, and/or high cholesterol) makes them very important in providing integrated care across the cardio-renal-metabolic spectrum.

Keywords

SGLT2 Inhibitor, Diabetes Mellites, Heart Attack, Protection, Weight Loss

Introduction

Diabetic patients have increased significantly in recent decades, mainly due to the rise in type 2 diabetes mellitus (T2DM). This trend leads to serious health, economic, and social challenges. [1] Treating diabetes is expensive, and the annual costs are rising. There are many antidiabetic drugs available that can be used alone or together. Each drug works differently, and its effects can change based on several factors, including the dose. Antidiabetic drugs aim to control glucose metabolism, primarily by lowering blood sugar levels. Consequently, many of these drugs may also help treat other conditions, especially obesity, which is a key contributor to diabetes mellitus (DM). [2] As a result, the variety of available drugs, their mechanisms, and biological effects have sparked much discussion across different health fields, including cardiovascular, kidney, neurological, and cancer-related areas. [3] Because diabetes is a complex disease, it requires a careful study when looking for new treatment targets or understanding how medications with potential antidiabetic effects work. [4] Furthermore, some, if not all, of these drugs can change cellular metabolism in ways that might help some organs but harm others. This presents a complicated challenge that hinders progress. [5] It has been noticed earlier that SGLT2 inhibitors are useful for increasing blood pressure, serum triglyceride levels, and body weight respectively [6–8]. The diabetic population is mostly prone to other factors of metabolic syndrome including cardiovascular diseases, and a protective role of SGLT2 inhibitors has been noticed for such conditions [9-11]

2. Role in Glycemic Management of Type 2 Diabetes Mechanism

SGLT2 cotransporters are located in the early PCT of the kidney, where they perform active glucose reabsorption in order to maintain optimum blood glucose levels [12]. SGLT2i medications act in an insulin-independent manner to selectively inhibit the reabsorption of glucose in the kidney and promote excretion via the urine [12]. Currently, three SGLT2i therapies are available for clinical use in the UK for the treatment of T2DM: canagliflozin (distributed in the UK by Napp Pharmaceuticals Limited), dapagliflozin (AstraZeneca UK Limited) and empagliflozin (Boehringer Ingelheim Limited) [13,14,15]. From a pharmacological perspective, all three therapies are very similar with regard to their mechanisms of action, although canagliflozin is known to also have affinity for SGLT1 cotransporters located in the suggest that this property may be important to the enhanced postprandial glucose-lowering action of canagliflozin 300 mg compared with canagliflozin 100 mg [13] intestine and kidneys [13]. Phase 3 studies.