title: Sodium-glucose cotransporter 2 inhibition and health benefits: The Robin Hood effect.
abstract: This review discusses two distinct, yet related, mechanisms of sodium-glucose cotransporter 2 (SGLT2) inhibition: Calorie restriction mimicry (CRM) and pro-ketogenic effect, which may explain their cardiovascular benefits. We term these adaptive CRM and pro-ketogenic effects of SGLT2 inhibition, the Robin Hood hypothesis. In English history, Robin Hood was a "good person," who stole from the rich and helped the poor. He supported redistribution of resources as he deemed fit for the common good. In a similar fashion, SGLT2 inhibition provides respite to the overloaded glucose metabolism while utilizing lipid stores for energy production.
authors.affiliation: Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Department of Medicine, Boehringer Ingelheim India Pvt, Ltd., Delhi, India.
authors.forename: Arpit
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Medicine, Boehringer Ingelheim Pvt Ltd, Mumbai, Maharashtra, India.
authors.forename: Jignesh
authors.initials: J
authors.lastname: Ved
authors.affiliation: Chellaram Diabetes Institute, Pune, Maharashtra, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Unnikrishnan
keywords: Calorie restriction mimicry canagliflozin; EMPA-REG outcome; cardiovascular outcomes; dapagliflozin; diabetes; empagliflozin; ketogenesis; ketogenic diet; liraglutide