A new trend in the treatment of type 2 diabetes mellitus with the use of sodium-dependent glucose transporter-2 inhibitors

Insulin is traditionally the main application point on which all methods for the management of type 2 diabetes mellitus are targeted. One of the new strategies for the treatment of this pathology utilizes sodium-dependent glucose transporter-2 (SGLT-2) inhibitors transforms this approach making kidneys the new point of application of antidiabetic therapy. SGLT-2 functions as a tunnel built into the epithelial wall of the initial segment of the proximal tubules in the nephron. When the channel is open, glucose is filtered into primary urine and can be reabsorbed in the proximal tubule. Based on this observation, the pharmaceutical companies began to search for the chemical substances that could be used to close the SGLT-2 tunnels and thereby interfere with the reverse flow of glucose from urine to blood, i.e. stimulate glycosuria. During the last decade, a few alternative molecules have been synthesized capable of selective inhibition of SGLT-2. At present, two of them, dapagliflozin and canagliflozin, are approved for the clinical application.