SGLT2 inhibitors – a useful addition to therapy?

SGLT2 stands for ‘sodium-glucose linked transporter 2’. This is a protein within the kidney tubules that regulates the reabsorption of glucose in the kidney. There is also, predictably, an SGLT1, which is present in both the kidney and the gut. In the kidneys, under normal circumstances, virtually all the glucose that passes into the urine from the blood is reabsorbed by the action of SGLT2. In diabetes, the abnormally high concentrations of glucose in the blood mean that this reabsorption mechanism in the kidney is overwhelmed, so that glucose passes into the urine – hence glycosuria (glucose in the urine) – one of the fundamental features of diabetes (and often the means by which it is first detected). A new class of drugs – SGLT2 inhibitors – is beginning to make an appearance as an oral anti-diabetes medication that may be used alone or in addition to other oral medications (such as metformin or sulphonylureas) or insulin for people with type 2 diabetes.