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SGLT-2 inhibitors for type 2 diabetes mellitus


SGLT-2 inhibitors are relatively new drugs for the treatment of type 2 diabetes mellitus. Ever since these SGLT-2 inhibitors have become available for the treatment of diabetes, their use has increased rapidly. Meta-analyses have meanwhile been published that summarise the evidence from various randomised studies. There have also been reports of rare but serious disorders associated with the use of these agents. Although the increased excretion of glucose in the urine would appear to be a useful option to control serum glucose levels, the effectiveness of these drugs on cardiovascular endpoints has so far only been proven for a limited subpopulation.

  • SGLT-2 inhibitors have mostly been studied in patients with type 2 diabetes mellitus whose glucose levels could not be sufficiently controlled using the prevailing guidelines.
  • A clinically relevant reduction of cardiovascular risk has exclusively been found in patients with a combination of type 2 diabetes mellitus and cardiovascular and/or renal disorders (secondary prevention).
  • In the absence of cardiovascular and/or renal disorders, SGLT-2 inhibitors should be reserved for patients whose serum glucose levels cannot be adequately controlled by means of lifestyle interventions and/or drugs with which more experience has been gained.
  • Some rare but serious disorders have been reported among users of SGLT-2 inhibitors, although causal class effects could not be unequivocally established.

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Authors

  • Sander van den Bogert, dr, pharmacist