Davis Courtney S, Fleming Joshua W, Warrington Laurie E
Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, Mississippi.
J Am Assoc Nurse Pract. 2014 Jul;26(7):356-63. doi: 10.1002/2327-6924.12135. Epub 2014 Jun 4.
The purpose of this article is to educate nurse practitioners about the newest class of oral medications developed to treat type 2 diabetes mellitus (T2DM). This article will review dapagliflozin and canagliflozin, the two Food and Drug Administration (FDA) approved sodium glucose co-transporter 2 (SGLT2) inhibitors, and discuss their place in therapy.
A comprehensive literature search was conducted using MEDLINE with the key terms: dapagliflozin, canagliflozin, SGLT2 inhibitors, and SGLT2 inhibitors. Other resources included the World Health Organization (WHO), U.S. FDA, Centers for Disease Control and Prevention (CDC), clinical guidelines, FDA labeling, briefings, and press releases.
Dapagliflozin and canagliflozin appear to be safe and moderately effective. SGLT2 inhibitors provide an alternative for dual and triple therapy for T2DM or can be used as monotherapy in patients who cannot tolerate other first-line options.
SGLT2 inhibitors have a unique, insulin-independent mechanism of action, targeting the kidneys. They have a low incidence of hypoglycemia and result in a moderate reduction in HbA1C. Improvements in weight, blood pressure, and lipid parameters have been demonstrated. Dosing considerations are required for the elderly, renally impaired, and patients at risk for hypotension.
本文旨在让执业护士了解用于治疗2型糖尿病（T2DM）的最新一类口服药物。本文将回顾达格列净和卡格列净这两种经美国食品药品监督管理局（FDA）批准的钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂，并讨论它们在治疗中的地位。
使用MEDLINE进行了全面的文献检索，关键词为：达格列净、卡格列净、SGLT2抑制剂和SGLT2抑制剂。其他资源包括世界卫生组织（WHO）、美国FDA、疾病控制与预防中心（CDC）、临床指南、FDA标签、简报和新闻稿。
达格列净和卡格列净似乎安全且有一定疗效。SGLT2抑制剂为T2DM的双联和三联治疗提供了一种选择，也可用于不能耐受其他一线治疗方案的患者的单药治疗。
SGLT2抑制剂具有独特的、不依赖胰岛素的作用机制，作用于肾脏。它们低血糖发生率低，能使糖化血红蛋白（HbA1C）适度降低。已证实其对体重、血压和血脂参数有改善作用。对于老年人、肾功能受损者以及有低血压风险的患者，需要考虑给药问题。
