What are SGLT2 inhibitors?
SGLT2 inhibitors, also called gliflozines, are drugs from the group of oral antidiabetics. They are therefore used to control blood sugar levels in diabetes mellitus. SGLT2 stands for a sugar transporter in the kidney.
The transporter absorbs the sugar back into the bloodstream and the inhibition ensures that more sugar is excreted with the urine. SGLT2 inhibitors are drugs that are completely independent of insulin. As a side effect, these drugs can also trigger hypoglycemia and have other local side effects.
Indications for SGLT2 inhibitors
The main indication for SGLT2 inhibitors is diabetes mellitus type 2, a condition in which there is too much sugar in the blood because their cells have become resistant to the body’s own insulin. Since this sugar damages the blood vessels and can therefore lead to kidney disease, heart disease, eye disease and nerve damage, this sugar level must be reduced. This is often achieved with a mixture of different active ingredients, including SGLT2 inhibitors.
SGLT2 inhibitors, unlike other oral antidiabetics, can also reduce body weight because the amount of sugar expelled means that the body has fewer calories available. Reducing body weight can even reduce diabetes in some people. In some cases, SGLT2 inhibitors are also used for diabetes mellitus type 1.
In this case, however, they must be combined with insulin, otherwise the body cells do not receive enough sugar. Only the excess sugar is additionally flushed out of the body. SGLT2 inhibitors are only approved for use in adult patients, as there are no study data yet on their use in children and adolescents.
The active ingredient in SGLT2 inhibitors
SGLT2 inhibitors are available under many different names. The active ingredient canagliflozine is marketed under the trade name Invokana®, dapagliflozine is available under the name Forxiga®. Empagliflozine is commercially called Jardiance® and Ertugliflozine is called Steglatro®.
Also approved are ipragliflozine under the name Suglat® and tofogliflozine under the names Apleway® or Deberza®. There are also other active ingredients in development. All of these compounds selectively inhibit, which means that they only have this mechanism in certain channels, the sodium glucose transporter SGLT2.
Normally, this transporter is responsible for the reabsorption of glucose from the urine into the bloodstream. When inhibited, more sugar is therefore excreted in the urine. This occurs completely independently of the insulin level in the blood, which distinguishes SGLT2 inhibitors from other oral antidiabetics.
Blood sugar levels therefore drop because the sugar is excreted from the body and is not brought into the cells as with other drugs. As a result, the body also loses calories directly and taking it can reduce body weight. This is also the reason why this drug is the only oral antidiabetic that can be used for diabetes mellitus type 1.
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