Vivian Eva
School of Pharmacy, University of Wisconsin, Madison, Wisconsin (Dr Vivian)
Diabetes Educ. 2015 Dec;41(1 Suppl):5S-18S. doi: 10.1177/0145721715607643. Epub 2015 Oct 8.
The purpose of this review article is to provide guidance to clinicians and diabetes educators regarding the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors as a therapeutic option for the treatment of patients with type 2 diabetes mellitus (T2DM).
The PubMed database was searched through February 2015 to identify clinical trials and meta-analyses evaluating the use of the SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin administered as monotherapy or in combination with other oral antidiabetes drugs or with insulin.
SGLT2 inhibitors reduce hyperglycemia in an insulin-independent manner by inhibiting the reabsorption of glucose into the systemic circulation by the kidneys. In patients with T2DM, SGLT2 inhibitors provide consistent reductions in glycated hemoglobin, fasting plasma and postprandial glucose, body weight, and blood pressure when used as monotherapy or in combination with other oral antidiabetes agents or with insulin. SGLT2 inhibitors are associated with a low risk of hypoglycemia, except when used with agents known to be associated with a higher risk of hypoglycemia, such as sulfonylureas or insulin.
The unique renal-specific mechanism of action and favorable efficacy and safety profile of SGLT2 inhibitors support consideration of these antidiabetes agents as a treatment option for patients with T2DM.
本综述文章旨在为临床医生和糖尿病教育工作者提供有关使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂作为治疗2型糖尿病（T2DM）患者的治疗选择的指导。
检索截至2015年2月的PubMed数据库，以识别评估SGLT2抑制剂卡格列净、达格列净和恩格列净作为单一疗法或与其他口服抗糖尿病药物或胰岛素联合使用的临床试验和荟萃分析。
SGLT2抑制剂通过抑制肾脏将葡萄糖重吸收进入体循环，以不依赖胰岛素的方式降低高血糖。在T2DM患者中，SGLT2抑制剂作为单一疗法或与其他口服抗糖尿病药物或胰岛素联合使用时，可使糖化血红蛋白、空腹血糖和餐后血糖、体重及血压持续降低。SGLT2抑制剂发生低血糖的风险较低，除非与已知低血糖风险较高的药物（如磺脲类或胰岛素）联合使用。
SGLT2抑制剂独特的肾脏特异性作用机制以及良好的疗效和安全性，支持将这些抗糖尿病药物作为T2DM患者的一种治疗选择。
