Department of Internal Medicine and Diabetes, Salamis Naval Hospital, Salamis, Greece.
Expert Rev Clin Pharmacol. 2013 Sep;6(5):519-39. doi: 10.1586/17512433.2013.827399. Epub 2013 Aug 26.
The role of the kidney in blood glucose-level regulation was until recently underestimated. Renal gluconeogenesis, renal glucose uptake and tubular glucose reabsorption are the three ways of renal involvement in glucose homeostasis. In the postabsorptive state, 20% of total glucose release is attributed to renal gluconeogenesis. Tubular glucose reabsorption is performed by the combined action of Na⁺/D-glucose SGLTs co-transporters and GLUT-facilitated diffusion glucose transporters. SGLT2 inhibitors are a new family of agents, which occlude the path of SGLT2 glucose reabsorption and cause glucosuria. Efficacy of SGLT2 inhibitors includes reduction of HbA1c, fasting and postprandial blood glucose level and slight body weight and systolic blood pressure decrease. The most common adverse events of them are genital mycotic and urinary tract infections. Dapagliflozin and canagliflozin are the first agents of this class, approved from the European Medicine Agency and FDA, respectively.
肾脏在血糖水平调节中的作用直到最近才被低估。肾糖异生、肾葡萄糖摄取和肾小管葡萄糖重吸收是肾脏参与血糖稳态的三种方式。在餐后状态下，20%的总葡萄糖释放归因于肾糖异生。肾小管葡萄糖重吸收是由 Na⁺/D-葡萄糖 SGLTs 协同转运体和 GLUT 促进扩散葡萄糖转运体的联合作用完成的。SGLT2 抑制剂是一类新型药物，可阻断 SGLT2 葡萄糖重吸收途径，导致糖尿。SGLT2 抑制剂的疗效包括降低 HbA1c、空腹和餐后血糖水平以及轻微的体重和收缩压下降。它们最常见的不良反应是生殖器霉菌和尿路感染。达格列净和卡格列净分别是欧洲药品管理局和美国食品药品监督管理局批准的该类药物中的第一批药物。
