title: Sodium-glucose co-transporter-2 inhibitors as add-on therapy to insulin: rationale and evidences.
abstract: Sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are recently approved class of anti-hyperglycaemic agents for the treatment of type 2 diabetes mellitus (T2DM). SGLT-2I inhibits renal glucose reabsorption, thereby ensuing urinary glucose excretion in a dose-dependent manner. This caloric loss and osmotic diuresis, secondary to increased urinary glucose excretion, has a unique potential to counter insulin induced weight gain and fluid retention, with little potential of hypoglycemic exacerbation. Also, as these agents act independently of insulin secretion or action, they are effective even in long-standing diabetes with depleted β-cell reserve. Improvement in insulin sensitivity, as observed with SGLT-2I can also facilitate insulin action. Furthermore, significant reduction in total daily insulin dosage and reduction of body weight as observed during combination therapy renders SGLT-2I, a near-ideal partner to insulin. This review aims to evaluate the safety and efficacy of currently used SGLT-2I as an add-on to insulin therapy in the treatment of T2DM.
authors.affiliation: a G.D Hospital & Diabetes Institute , Kolkata , India.
authors.forename: Awadhesh Kumar
authors.initials: AK
authors.lastname: Singh
authors.affiliation: a G.D Hospital & Diabetes Institute , Kolkata , India.
authors.forename: Ritu
authors.initials: R
authors.lastname: Singh
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use; D007333:Insulin Resistance; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D005947:Glucose
keywords: Sodium glucose co-transporter-2 inhibitors; genito-urinary infection; hypoglycemia; insulin; type 2 diabetes