Managing diabetes often requires the use of medications in order to reach glycemic goals and to prevent long-term complications of diabetes. SGLT2 inhibitors are one class of medications that are an option for individuals with type 2 diabetes. Examples of SGLT2 inhibitors includes Canagliflozin (Invokana), Dapagliflozin (Farxiga) and Empagliflozin (Jardiance). These medications work in a unique way to help control blood sugar levels compared to other diabetes medications. They also offer additional health benefits beyond glycemic control.
How SGLT2 Inhibitors Work:
SGLT2 inhibitors, or sodium-glucose cotransporter 2 inhibitors, are oral medications designed to lower blood sugar levels by excreting sugar in the urine. The kidneys normally reabsorb glucose from the urine back into the bloodstream. SGLT2 inhibitors prevent this process, allowing extra glucose to be excreted in the urine, thereby reducing blood sugar levels.
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Benefits of SGLT2 Inhibitors:
Glycemic Control: SGLT2 inhibitors effectively lower blood sugar levels, helping individuals with type 2 diabetes achieve better glycemic control. They can be used alone or in combination with other diabetes medications. They can lower A1c levels by up 0.6-1.2% depending on the individual.
Weight Loss: SGLT2 inhibitors are associated with modest weight loss due to the excretion of glucose in the urine. This benefit can be especially valuable for individuals who need to lose weight to improve their diabetes management and overall health.
Blood Pressure Reduction: SGLT2 inhibitors have been shown to lower blood pressure, contributing to overall cardiovascular health. This effect can be beneficial for individuals with diabetes who have high blood pressure and are at a higher risk of heart-related complications.
Cardiovascular Protection: Some SGLT2 inhibitors have demonstrated cardiovascular benefits. They have been associated with reduced risks of heart failure, heart attacks, and stroke in certain individuals with type 2 diabetes and a history of cardiovascular disease.
Kidney Protection: SGLT2 inhibitors may offer kidney-protective effects by reducing the risk of kidney disease progression in individuals with diabetes and kidney impairment.
Potential Side Effects:
While SGLT2 inhibitors offer numerous benefits, it’s important to be aware of potential side effects and considerations:
Genital Infections: SGLT2 inhibitors may increase the risk of genital infections, such as yeast infections in women and urinary tract infections in both men and women.
Dehydration and Low Blood Pressure: These medications may lead to dehydration and low blood pressure, especially in individuals taking diuretics or those with kidney issues. Ensuring adequate fluid intake and staying hydrated is important when taking an SGLT2 inhibitor.
Ketoacidosis: While rare, SGLT2 inhibitors may increase the risk of diabetic ketoacidosis (DKA), a serious condition characterized by high levels of ketones in the blood.
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SGLT2 inhibitors represent a valuable addition to the array of diabetes medication management options. With the unique way that they work to reduce blood sugar, and additional health benefits they offer, these medications can be a helpful tool in managing blood sugar levels and promoting overall health. As with any medication, it’s crucial to work closely with a healthcare professional to determine the most appropriate treatment plan based on individual needs and health considerations.
2) Padda IS, Mahtani AU, Parmar M. Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors. [Updated 2023 May 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576405/
3) The role of SGLT-2 inhibitors in managing type 2 diabetes. Yumiko Tsushima, M. Cecilia Lansang, Vinni Makin. Cleveland Clinic Journal of Medicine Jan 2021, 88 (1) 47-58; DOI: 10.3949/ccjm.88a.20088