Gomez-Peralta Fernando, Abreu Cristina, Lecube Albert, Bellido Diego, Soto Alfonso, Morales Cristóbal, Brito-Sanfiel Miguel, Umpierrez Guillermo
Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain.
Endocrinology and Nutrition Unit, Hospital Universitari Arnau de Vilanova de Lleida, Institut de Recerca Biomèdica de Lleida, CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas, ISCIII), University of Lleida, Lleida, Spain.
Diabetes Ther. 2017 Oct;8(5):953-962. doi: 10.1007/s13300-017-0277-0. Epub 2017 Jul 18.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an attractive novel therapeutic option for the treatment of type 2 diabetes. They block the reabsorption of filtered glucose in kidneys, mainly in proximal renal tubules, resulting in increased urinary glucose excretion and correction of the diabetes-related hyperglycemia. Beyond improving glucose control, SGLT2 inhibitors offer potential benefits by reducing body weight and blood pressure. On the basis of the efficacy demonstrated in clinical trials, SGLT2 inhibitors are recommended as second- or third-line agents for the management of patients with type 2 diabetes. Beneficial effects on kidney disease progression, cardiovascular and all-cause mortality, and hospitalization for heart failure have also been demonstrated with one SGLT2 inhibitor (empagliflozin). Potential adverse events resulting from their mechanism of action or related to concomitant therapies are reviewed. A treatment algorithm for the adjustment of concomitant therapies after initiating SGLT2 inhibitors is also proposed.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂是治疗2型糖尿病的一种颇具吸引力的新型治疗选择。它们可阻断肾脏中滤过葡萄糖的重吸收，主要是在近端肾小管，从而导致尿糖排泄增加并纠正糖尿病相关的高血糖。除改善血糖控制外，SGLT2抑制剂还可通过减轻体重和降低血压带来潜在益处。基于临床试验中所证实的疗效，SGLT2抑制剂被推荐作为治疗2型糖尿病患者的二线或三线药物。一种SGLT2抑制剂（恩格列净）对肾脏疾病进展、心血管和全因死亡率以及因心力衰竭住院治疗也已显示出有益作用。本文综述了由其作用机制或与伴随治疗相关的潜在不良事件。还提出了启动SGLT2抑制剂后调整伴随治疗的治疗算法。
