Sglt-2 Inhibitors

Key points

• SGLT-2 inhibitors SGLT-2 inhibitors reversibly inhibit sodium-glucose co-transporter 2 (SGLT-2) in the renal proximal convoluted tubule to reduce glucose reabsorption and increase urinary glucose excretion.
• urinary and genital infection (secondary to glycosuria). Fournier's gangrene has also been reported
• normoglycaemic ketoacidosis
• LOWER-LIMB AMPUTATION — note this is NOT a confirmed class effect. The signal came from the CANVAS trials of CANAGLIFLOZIN; the FDA REMOVED its boxed warning in 2020 after further data, retaining a standard warning. Dapagliflozin and empagliflozin have not shown the same association. Maintain good foot care and monitor feet, particularly in those with neuropathy, peripheral arterial disease or prior amputation.
• Patients taking SGLT-2 drugs often lose weight, which can be beneficial in type 2 diabetes mellitus.