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In yesterday’s blog, I cited in its entirety an article by DavidJ_PLMin in which he cited two new drugs that show promise in the treatment of CKF. In this blog, we will investigate the first of the two cited, namely sodium-glucose cotransporter 2 (SGLT2).To accomplish this I turned to my AI right hand Poe. Poe has a customized bot named DoctorSage that addresses medical questions. I queried the bot with the following prompt and results:

Prompt: There is a new drug used in treating CKD named sodium-glucose cotransporter 2 (SGLT2). Tell me everything there is to know about this treatment.

DoctorSage DoctorSage Poe

Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) are a relatively new class of medications used in the treatment of chronic kidney disease (CKD). These medications work by inhibiting the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion. This mechanism of action not only helps in controlling blood sugar levels but also offers potential benefits in managing CKD. Here’s everything you need to know about SGLT2 inhibitors:

  1. Mechanism of action: SGLT2 inhibitors primarily target the SGLT2 transporter located in the proximal tubules of the kidneys. By inhibiting this transporter, they prevent the reabsorption of glucose, resulting in increased glucose excretion in the urine.
  2. Glycemic control: SGLT2 inhibitors are primarily used in the management of type 2 diabetes mellitus (T2DM). By reducing renal glucose reabsorption, these medications lower blood glucose levels, leading to improved glycemic control. They can be used as monotherapy or in combination with other antidiabetic medications.
  3. Cardiovascular benefits: SGLT2 inhibitors have shown significant cardiovascular benefits in patients with T2DM and established cardiovascular disease (CVD). Studies have demonstrated a reduction in the risk of major adverse cardiovascular events, including heart attack, stroke, and cardiovascular death, with the use of SGLT2 inhibitors.
  4. Renal benefits: The use of SGLT2 inhibitors has shown promising results in preserving kidney function and preventing the progression of CKD. These medications have been associated with a reduction in albuminuria (the presence of albumin in the urine) and a decrease in the risk of end-stage renal disease (ESRD) or the need for renal replacement therapy.
  5. Blood pressure and weight reduction: SGLT2 inhibitors have been found to have a mild blood pressure-lowering effect. Additionally, they promote weight loss, which can be beneficial in patients with T2DM who are overweight or obese.
  6. Adverse effects: The most common side effects of SGLT2 inhibitors include urinary tract infections, genital fungal infections, and increased urination. There have been rare cases of euglycemic diabetic ketoacidosis (DKA), a serious condition characterized by elevated ketone levels in the absence of high blood sugar levels. Therefore, it is essential to monitor for signs of DKA, especially in patients with T1DM or a history of DKA.
  7. Contraindications and precautions: SGLT2 inhibitors should be used with caution in patients with impaired renal function, as they may increase the risk of acute kidney injury. They are contraindicated in patients with severe renal impairment or end-stage renal disease. It is important to assess renal function before starting treatment and regularly monitor renal function during therapy.

It’s worth noting that specific SGLT2 inhibitors available in the market may have slight differences in their pharmacokinetics and clinical effects. Therefore, it is crucial to consult the prescribing guidelines and individual drug information for detailed information on specific SGLT2 inhibitors.

A listing of SGLT2 drugs is provided at this link for further information.