Sodium,glucose cotransporter 2 inhibitors in the treatment of Type 2 diabetes: a review of Phase II and III trials

Author(s): Mark S Kipnes

As a result of the progressive nature of Type 2 diabetes, novel, insulinindependent therapies are needed to reduce blood glucose, without increasing body weight. A new class of investigational drugs, sodium–glucose cotransporter 2 (SGLT2) inhibitors, remove glucose from circulation via the kidney. Several SGLT2 inhibitors in development (dapagliflozin, canagliflozin, ASP1941, BI10773 and LX4211) have demonstrated improvement in glycemic control and weight loss. Because renal glucose reabsorption is independent of insulin action or secretion, SGLT2 inhibition may be a versatile mechanism with utility as monotherapy and in combination with oral antidiabetics and/or insulin, and has a low potential for hypoglycemia. Heightened concern over the long-term cardiovascular risks posed by hypoglycemia as well as obesity may eventually drive the use of this class earlier in the treatment paradigm.