Role of Sodium Glucose Co-Transporter-2 Inhibitors in Pre-diabetes and Their Extra-glycemic Effects

The burden of diabetes mellitus and pre-diabetes has been extensively increasing over the past few years. Selective sodium-glucose co-transporters inhibitors were extensively studied in type 2 diabetes mellitus and were found to have sustained urinary glucose loss, improvement in glycemic control, in addition to their proven metabolic effects. Although they sound to be promising, there is still no clear data regarding their use in the prevention of diabetes, in pre-diabetic individuals, a subset of patients who are at increased risk of development of type II diabetes and its complications. Moreover, sodium-glucose co-transporters inhibitors were found to have multiple extra-glycemic beneficial effects, including weight loss, blood pressure reduction and beneficial effects on the kidneys. Therefore, their use in pre-diabetes is postulated to be beneficial on glucose and metabolic profile and larger studies need to be conducted in this subset of population.