Keywords: SGLT2-inhibitors, diabetic agents
AbstractThe on-going search for new therapeutic diabetic agents has led to the focus being redirected to the kidney, and its role in glucose homeostasis.1 The kidney primarily achieves glucose homeostasis through its ability to reabsorb the glucose that is filtered into the glomerular filtrate. Almost all the glucose that is filtered is reabsorbed and returned into the circulation in healthy individuals, which results in minimal or no glucose being excreted in the urine.1,2 Patients with type 2 diabetes (T2DM) have, amongst a number of pathological defects, an increased reabsorption (20–40%) of glucose in the kidneys.1,3 Clinical studies of the sodium-glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin, dapagliflozin and empagliflozin, compared to placebo, have shown marked improvements in glycaemic control.2 Currently in South Africa, only dapagliflozin (Forxiga®) is registered for use in patients with T2DM.4
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