Abstract
Kidneys substantially affect glucose metabolism in human body owing to renal glucose reabsorption and its contribution to gluconeogenesis. A novel group of antidiabetic drugs based on the inhibition of SGLT 2 transporters responsible for renal glucose reabsorption is currently being introduced to clinical practice.
SGLT 2 inhibition increases renal glucose excretion with subsequent decrease of blood glucose and improvement of diabetes compensation. At the moment, numerous SGLT 2 inhibitors are under development.
The aim of this paper is to summarize the mechanism of action of SGLT 2 inhibitors and their position in the current treatment algorithm of type 2 diabetes mellitus. We will specifically focus on dapagliflozin which will be soon available in Czech Republic.
This medication is currently approved for the treatment of type 2 diabetes in combination with other antidiabetic drugs including insulin or as monotherapy in patients with metformin intolerance. In addition to improvement of diabetes compensation, dapagliflozin treatment slightly decreases body weight and blood pressure.
The advantage of SGLT 2 inhibitors lies in its unique mechanism of action complementary to the effect of other types of antidiabetic drugs and the fact, that they do not induce hypoglycemia.