SGLT-2 Inhibitors and other medications
Affecting the lives of nearly 285 million people worldwide, diabetes is a global epidemic. And that number is projected to increase by 54% in the year 2030 –with the majority being newly diagnosed type 2 diabetes (T2DM) cases.
Now, UF Health investigators are evaluating population-based studies to compile a list of alternative drugs that may one day be used to treat these new cases. This set of novel medications may have significant implications for future management and treatment of T2DM. According to recent articles published in the American Journal of Therapeutics and Dove Medical Press, UF researchers note that the need for traditional medications such as metformin tends to increase over time in patients with the disease. But numerous clinical trials underway have the potential to slow disease progression and complications without the need for more drugs.
On the list of current investigational medications include a group of agents known as sodium-glucose cotransporter 2 (SGLT2) inhibitors. These work by blocking the reabsorption of blood sugar by the kidney(s); increasing glucose excretion and lowering blood glucose levels (Note: SGLT1’s are mainly expressed in the intestines). Two SGLT2 inhibitors are now available on the U.S. market — canagliflozin (Invokana) and dapagliflozin (Farxiga), with several others currently in various early stages of clinical development.
In several clinical studies, dapagliflozin “seem[s] to be well tolerated with no serious adverse effects.” According to the FDA, “dapagliflozin should not be used by patients who have type 1 diabetes, increased ketones in their blood or urine, moderate or severe renal impairment, end-stage renal disease, or those on dialysis. Nor should patients with active bladder cancer receive the drug.”
Other potential medications mentioned in the article include: GLP-1 agonists (ie liraglutide), low calorie sweeteners (Tagatose), and antioxidants (ie Succinobucol). With more clinical investigations underway, the hope is that novel drugs like these will fill a needed gap in patient care.
- Lo, Margaret C.; Lansang, M. Cecilia. Recent and Emerging Therapeutic Medications in Type 2 Diabetes Mellitus: Incretin-Based, Pramlintide, Colesevelam, SGLT2 Inhibitors, Tagatose, Succinobucol. American Journal of Therapeutics (20): 638–653 (2013).
- Anderson M, Powell J, Campbell KM, Taylor JR. Optimal management of type 2 diabetes in patients with increased risk of hypoglycemia. Diabetes Metab Syndr Obes (7) :85-94 (2014).