Premium
Impact of Sodium‐Glucose Cotransporter 2 Inhibitors on Nonglycemic Outcomes in Patients with Type 2 Diabetes
Author(s) -
Trujillo Jennifer M.,
Nuffer Wesley A.
Publication year - 2017
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1903
Subject(s) - empagliflozin , medicine , dapagliflozin , canagliflozin , type 2 diabetes , diabetic ketoacidosis , diabetes mellitus , adverse effect , intensive care medicine , glycemic , renal glucose reabsorption , endocrinology
The efficacy of the sodium‐glucose cotransporter 2 ( SGLT 2) inhibitors canagliflozin, dapagliflozin, and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In addition, positive effects have been observed with these agents on nonglycemic variables, such as reductions in body weight and blood pressure, which may confer additional health benefits. SGLT 2 inhibitors are also associated with evidence of renal‐protecting benefits. Furthermore, during the landmark Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes ( EMPA ‐ REG OUTCOME ) trial, a substantial reduction in major adverse cardiovascular outcomes was demonstrated with empagliflozin therapy. In view of the complex pathogenesis of cardiovascular disease in patients with diabetes, a pharmacologic intervention for type 2 diabetes that produces a multifaceted reduction in cardiovascular disease risk, separate from glycemic control alone, would be advantageous. Although SGLT 2 inhibitors are generally well tolerated, they are associated with an increased risk of genital mycotic infections, as well as the potential risk for serious adverse events such as dehydration, development of diabetic ketoacidosis, serious urinary tract infections, and bone fractures. The findings of ongoing research will help to determine the magnitude and clinical importance of these adverse events and whether the findings of EMPA ‐ REG OUTCOME represent a class effect for SGLT 2 inhibition or are specific to empagliflozin and will further elucidate the future role of SGLT 2 inhibitors in the individualized management of patients with type 2 diabetes. In this article, we discuss the nonglycemic outcomes associated with SGLT 2 inhibitor therapy in patients with type 2 diabetes as well as the clinical implications of these agents.