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SGLT-2 inhibitors
What is SGLT-2 inhibitors ?
Sodium-glucose co-transporter 2 or SGLT-2 inhibitors are prescription oral drugs for the treatment of type 2 diabetes. SGLT2 inhibitors reduce glucose in the blood by blocking the action of the protein sodium-glucose co-transporter-2 or SGLT2 in the kidney. This protein reabsorbs blood sugar back into the body from urine. Blocking the protein stops the kidney from reabsorbing glucose from urine, causing the removal of glucose from the body through urine and resulting in a lower level of glucose in the blood.
SGLT2 inhibitors also lower blood pressure, causing the person to lose weight. A study found that empagliflozin significantly reduces the risk of death from cardiovascular causes, death from any cause, and the risk of hospitalization for heart failure in people with type 2 diabetes. The first SGLT inhibitor – canagliflozin was approved by the FDA in 2013.
More information
SGLT2 inhibitors may be used alone or together with metformin and other diabetic medications together with diet and exercise to reduce blood glucose in adults with type 2 diabetes. SGLT inhibitors are not used for the treatment of type 1 diabetes or the treatment of diabetic ketoacidosis. This invokana drug should not be prescribed to patients with kidney disease including those undergoing dialysis.
Warning and side effects
The FDA issued a warning on Aug. 29, 2018, that cases or rare but serious infection of the genitals and areas around the genitals have been reported with the class of type of 2 diabetes medicines called SGLT inhibitors. The rare infection – necrotizing fasciitis of the perineum, is also referred to as Fournier’s gangrene.
SGLT2 inhibitors are approved for use with exercise and diet to lower blood sugar in adults with type 2 diabetes. The medicine lowers blood sugar by causing the kidneys to remove sugar from the body through the urine.
You should seek medical attention if you experience any symptoms of redness, tenderness, or swelling of the genitals or the area from the genitals to the rectum, and have a fever above 100.4°F or a general feeling of being unwell. These symptoms may worsen quickly, making it very important to seek treatment right away.
The FDA also informed the public in 2015 that SGLT 2 inhibitors have been associated with increased risk of ketoacidosis in people with diabetes.
The common side effects of SGLT inhibitors include:
- Urinary tract infection
- Genital yeast infections in men and women
- Increased urination
- Flu-like symptoms
- Kidney problems
- Constipation
- Urinary discomfort
- Nasal congestion
- Back pain
Serious side effects of SGLT inhibitors include:
- Kidney failure
- Hypotension
- Hyperkalemia
- Ketoacidosis
- Increased cholesterol levels
- Increased bladder cancer risk
- Serious urinary tract infection
- Serious allergic reactions
- Dehydration
- Low blood glucose when combined with insulin or drugs that increase the production of insulin
SGLT inhibitors have not been adequately evaluated for use in pregnant women. It may affect kidney development and maturation in animals.
It is also not known yet if SGLT inhibitors are secreted in human breast milk. Breastfeeding women should not take SGLT2 inhibitors and breastfeed at the same time.