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Is it time to think about the sodium glucose co‐transporter 2 sympathetically?
Author(s) -
Elliott Rosemary H,
Matthews Vance B,
Rudnicka Caroline,
Schlaich Markus P
Publication year - 2016
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12620
Subject(s) - renal glucose reabsorption , endocrinology , medicine , glucose transporter , reabsorption , diabetes mellitus , renal sodium reabsorption , glucose homeostasis , sympathetic nervous system , transporter , homeostasis , type 2 diabetes , carbohydrate metabolism , sodium , kidney , chemistry , insulin , biochemistry , insulin resistance , blood pressure , organic chemistry , gene
Disturbances in glucose homeostasis are a key feature of the metabolic syndrome and type 2 diabetes. Renal glucose reabsorption is an important factor in glycaemic control. Glucose reabsorption in the proximal tubules is mediated by the sodium glucose co‐transporter 2. The capacity for glucose reabsorption is increased in type 2 diabetes and contributes significantly to hyperglycaemia and impaired glucose control. Understanding the mechanisms underpinning the regulation of the sodium glucose co‐transporter 2 is therefore of high clinical relevance. However, despite recent advances in the field and the availability of pharmacological inhibitors of this glucose transporter for the treatment of type 2 diabetes, the mechanisms that regulate sodium glucose co‐transporter 2 expression are not fully understood. The sympathetic nervous system is an important modulator of glucose homeostasis, and sympathetic hyperactivity is a characteristic feature of obesity, the metabolic syndrome and type 2 diabetes. Sympathetic inhibition either achieved pharmacologically or by renal sympathetic denervation has been associated with improved glucose control. Importantly, sympathetic nerves innervate the proximal tubules of the kidney where they have been shown to regulate the expression of other transporters such as the sodium hydrogen exchanger 3. This review aims to explore the evidence for the regulation of sodium glucose co‐transporter 2‐mediated glucose reabsorption by the sympathetic nervous system.