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Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives

The treatment of type 2 diabetes is a challenging problem. Most subjects with type 2 diabetes have progression of beta cell failure necessitating the addition of multiple antidiabetic agents and eventually use of insulin. Intensification of insulin leads to weight gain and increased risk of hypoglyc...

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Autores principales: John, Mathew, Gopinath, Deepa, Jagesh, Rejitha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743379/
https://www.ncbi.nlm.nih.gov/pubmed/26904465
http://dx.doi.org/10.4103/2230-8210.172268
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author John, Mathew
Gopinath, Deepa
Jagesh, Rejitha
author_facet John, Mathew
Gopinath, Deepa
Jagesh, Rejitha
author_sort John, Mathew
collection PubMed
description The treatment of type 2 diabetes is a challenging problem. Most subjects with type 2 diabetes have progression of beta cell failure necessitating the addition of multiple antidiabetic agents and eventually use of insulin. Intensification of insulin leads to weight gain and increased risk of hypoglycemia. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of antihyperglycemic agents which act by blocking the SGLT2 in the proximal tubule of the kidney. They have potential benefits in terms of weight loss and reduction of blood pressure in addition to improvements in glycemic control. Further, one of the SGLT2 inhibitors, empagliflozin has proven benefits in reducing adverse cardiovascular (CV) outcomes in a CV outcome trial. Adding SGLT2 inhibitors to insulin in subjects with type 2 diabetes produced favorable effects on glycemic control without the weight gain and hypoglycemic risks associated with insulin therapy. The general risks of increased genital mycotic infections, urinary tract infections, volume, and osmosis-related adverse effects in these subjects were similar to the pooled data of individual SGLT2 inhibitors. There are subsets of subjects with type 2 diabetes who may have insulin deficiency, beta cell autoimmunity, or is prone to diabetic ketoacidosis. In these subjects, SGLT2 inhibitors should be used with caution to prevent the rare risks of ketoacidosis.
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spelling pubmed-47433792016-02-22 Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives John, Mathew Gopinath, Deepa Jagesh, Rejitha Indian J Endocrinol Metab Review Article The treatment of type 2 diabetes is a challenging problem. Most subjects with type 2 diabetes have progression of beta cell failure necessitating the addition of multiple antidiabetic agents and eventually use of insulin. Intensification of insulin leads to weight gain and increased risk of hypoglycemia. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of antihyperglycemic agents which act by blocking the SGLT2 in the proximal tubule of the kidney. They have potential benefits in terms of weight loss and reduction of blood pressure in addition to improvements in glycemic control. Further, one of the SGLT2 inhibitors, empagliflozin has proven benefits in reducing adverse cardiovascular (CV) outcomes in a CV outcome trial. Adding SGLT2 inhibitors to insulin in subjects with type 2 diabetes produced favorable effects on glycemic control without the weight gain and hypoglycemic risks associated with insulin therapy. The general risks of increased genital mycotic infections, urinary tract infections, volume, and osmosis-related adverse effects in these subjects were similar to the pooled data of individual SGLT2 inhibitors. There are subsets of subjects with type 2 diabetes who may have insulin deficiency, beta cell autoimmunity, or is prone to diabetic ketoacidosis. In these subjects, SGLT2 inhibitors should be used with caution to prevent the rare risks of ketoacidosis. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4743379/ /pubmed/26904465 http://dx.doi.org/10.4103/2230-8210.172268 Text en Copyright: © Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Review Article
John, Mathew
Gopinath, Deepa
Jagesh, Rejitha
Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title_full Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title_fullStr Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title_full_unstemmed Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title_short Sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: Clinical perspectives
title_sort sodium-glucose cotransporter 2 inhibitors with insulin in type 2 diabetes: clinical perspectives
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743379/
https://www.ncbi.nlm.nih.gov/pubmed/26904465
http://dx.doi.org/10.4103/2230-8210.172268
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